by “We are going to have to use creativity,” said the source, alluding to an idea that is gaining consensus among prepaid managers: the design of coverage proposals with cuts, low cost airplanes in response to the challenge of the sector to adjust its fees (in January alone, close to 40%) and, at the same time, maintain the affiliate portfolio without suffering a mass exodus.
The person who spoke of “creativity” did so on behalf of the Argentine Health Union (UAS), an entity at the core of none other than 1,500 institutionsbetween chambers and prepaid associations, sanatoriums and other providers.
Concern is on everyone’s lips, small and large businessmen. Although they denounce a brutal defunding of the sector (depending on who you ask, the red in the 2023 quotas ranges between 40 and 70 points, they say), it is understood that rebuilding what was lost from one month to the next would have an unbearable cost, due to the affiliate withdrawals that it would represent.
The plan (although each company will do what it wants, they emphasize) has at least two important sides.
On the one hand, adjust installments month by month at the rate of inflation, plus a bonus in the name of the points resigned in 2023, which will be applied to members in comfortable installments. Some speak of six months; others, one year.
On the other hand (and in parallel) they offer proposals for cheaper planes to maintain loyalty, since, it is known, the salary is not only not keeping up with inflation but they are light years away from being able to afford installments with a bonus above it. .
All this occurs in a context of great tensions throughout the year, between Illegal co-payments, missing supplies, reduced cards and users who, due to unstoppable inflation, had to cancel their plan or directly cancel.
No one was offered to have a lower fee in exchange for staying in prepaid, a strategy that for years was popular (due to its success) in negotiations with cable, internet or cell phone companies.
However, it does not seem crazy to estimate that something similar could begin to occur in the relationship between consumers and prepaid companies.
As long as Javier Milei’s decree does not receive a legislative or judicial setback, the new rules that will govern the sector, especially the possibility of setting the quotas to the liking of each company (without the forceps of the authorizations of increases that the Government gave) will make it possible something that until now occurred in a very lukewarm form: competition.
With the same logic as the traditional pot of dulce de leche, one day it eliminated its classic half-kilo presentation and began to offer, for the same price, a lean option with 20% less content, prepaid health could also be converted.
What would low cost airplanes be like?
References of companies that have been speaking with Clarion Every day since the decree they insistently emphasize how the regulations (“if we don’t go back,” they take a shortcut) will completely change the equation of the business that has been stagnant for years, an aspect that may be difficult for the consumer to dimension, but which the entities It is a small revolution for them.
“The deregulation of quotas opens the competition between companies would define a source in the sector, as if it were something completely new.
At some point, it is. It is enough to remember that until now the companies could all increase the same amount and that they all complained about the insufficiency of the authorized percentages, much lower – they pointed out – than the increases they had to face in areas (unavoidable for practice) such as disposable supplies. . , medications and, even, the salaries of health professionals.
The new scenario gives them wide freedom in terms of fees and services to be provided, beyond the basic coverage of the Mandatory Medical Plan (PMO), which they must guarantee.
What types of proposals? low cost Are they shuffled? One source defined them as “partial planes.” Some examples that are thought They only include hospitalizationfor example, or hospitalization in cases of surgery.
The director of a large entity said that they were considering designing “plans that cover high-cost illnesses and treatments” (also called “catastrophic”) or, conversely, “plans that include everything except high-cost treatments and medications.” Or, “on the other hand, that they include them in a reduced form,” she added.
If the trend towards cheaper airplanes is consolidated, it is logical to estimate – as another spokesperson suggested – that proposals will appear with a small limit of annual consultations and practices; prepayments without dental plan or without rehabilitation coverageto add examples.
And, in the cases of entities that have not already done so, options can be provided with very limited primerswhich one source directly defined as “starting to offer completely closed plans.”
Prepaid, less for more?
“The idea is to progressively recover what was lost in these years of defunding, but the problem is very high inflation, at least until March,” shared a manager who several times insisted on the need to “balance” to protect the client portfolio: “We know that some are going to fall out of the system, but it has to be as few as possible.”
The reason for this need is directly related to the expansion of the sector, which refers to a short historical story.
“Years ago (recorded), many who derived their contributions to a social work realized that with a little more they had the possibility of facing a prepaid payment. Salaries exceeded inflation.”
This trend meant that between the 90s and today, the client portfolio practically doubled. It reached nearly 6 million people, according to industry estimates.
The issue is that those 6 million people are only 15% of the population that uses the private health system in Argentina, between sanatoriums and diagnostic centers, either through prepaid payments or by referral from a social work or public hospital. And what proportions of the population ultimately use the private health system? Nothing less than 70%.
“The growth of private medicine in recent years generated an expansion in structures: sanatoriums, diagnostic centers, equipment and booklets, to a point that, if your clients dwindle, you will have a lot of idle structural resource. Who cares about that,” admitted another source.
It is seen that All roads lead to low cost airplanes: “Simulations were done with a lot of numbers. It is evident that it is of no use and that half of the wallet falls out. The increase in fees must be prudent and responsible. Gradual. “Each company will design its strategy.”
