Illegal acts are denounced, but are not sanctioned and affect even the provision of medicines. The State’s debt amounts to more than $8,000 million. Urgent reforms are needed.
The Ecuadorian Social Security Institute (IESS) It is one of the main entities in the country, but corruption and political mismanagement have led to chaos.
Below are 10 key points to understand the reality that the country is currently going through. IESS:
- The political manipulation has caused a bankruptcy in slow motion. The funds are ill-formed and underfunded, especially those of Health Y retirement. Services were expanded with full coverage, but without financing: children under 18 years of age affiliates, catastrophic and chronic diseases. For a few years, these services could be covered by spending the institution’s savings, but that is no longer possible. The State has not fulfilled its role of contributing to finance all these commitments
- The state’s debt to the IESSonly on the subject of Healthreaches $4,526 million and has to be paid immediately, because the health fund it only has a $90 million expense reserve, and each year a deficit of $520 million. If it is added to retirement fundunfulfilled state obligations reach $8.3 billion
- The President of the Board of Directors, Francis Cepeda, ensures that structural reforms to the system should start with set a copay system. For example, a minimum fee of $1 for each care. In addition, an automatic payment mechanism must be established from the State (Ministry of Health) to the IESSespecially when delivered medicines for chronic diseasesrare and cancer.
- In the case of retirement insurance, you must inevitably walk towards the increase in retirement age and the percentage of contributions. However, the reforms will be implemented in the medium and long term, after a process of dialogue and consensus with various sectors.
- Progress is recorded in the payment of the state debt. In the 2022 state budget, an additional $1 billion was included for the payment of old debts to the IESS. This is part of the transfers that each year must be made by law due to the 40% of the State’s contribution to the pension fund. Most of that $1 billion is expected to go to Health.
- Currently, the IESS has 3.6 million affiliatesbut most are volunteers and housewives with low contribution rates. The retirees exceed 580,000 people. Every month about $700 million are received for contributions and of that 5% goes to the health fund. The money is not enough because the institution provides services of Health to 9.8 million people, that is, almost three times more than the affiliates assets.
- The employer’s delinquent portfolio amounts to $1,400 million. Of that total, about $800 million correspond to affiliates volunteers, which includes the unemployed and even migrants who have left the country. Every day interest is generated and it becomes a snowball. In the last four months it has been possible to collect $400 million.
- Corruption is everywhere. Dozens of complaints have been found stored in the drawers of the Attorney General’s Office. IESS. From September 2021 to date, 12 complaints have been filed with the Prosecution for embezzlement, briberyinfluence peddling, extortion, attack on the integrity of computer systems, intimidation of officials
- On February 3, 2022, a bribery collection network was detected to expedite payments to external providers and suppliers. Three officials were arrested in flagrant crime, but in less than 24 hours the three detainees were released free and without any charges. A null management from the Prosecutor’s Office is denounced.
The network controls medical audits and manipulates provider payments for your benefit. A subscription payment of $5,000 is requested and then 3% of each disbursement payment.
Invoices are left behind on purpose to give priority only to those who pay bribes. The aim is to implement a system that disburses everyone proportionally to the service or product received by the customer. IESS.
- From September 2021 to date, the drug supply at IESS it went from 47% to 78%. What is most missing are drugs for chronic diseases and cancer. Negligently, several contracts were not signed on time and each hospital is being investigated.
According to the President of the Board of Directors of the IESS there is no reason for the lack of medical supplies, because there are the necessary budgets. The problems in this case are also related to corruption networks.
Medicine purchases are seriously hindered by an inefficient and unrefined system of public purchases. For example, there are dozens of qualified suppliers that have business names or activities declared without no relationship with the provision of drugs.
Cepeda denounced that the director of the National Public Contracting Service (Sercop), María Sara Jijón, told him that nothing can be done if they are already approved in the system. (JS)
