The Association of Isapres reiterated this Thursday “that the sector is in a critical situation”, after the latest comments by the Minister of Health, María Begoña Yarza, who was skeptical since she said that they have had good results in the last 15 or 20 years, recording losses only in 2021.
“I don’t think that (the fall of an isapre) will happen, given this more long-term look, I imagine that there are resources saved for these moments,” he commented this week. And in case something like that happened, she said that “the law has a way to solve that today,” the minister said this week. “I also think that these organizations are organized in a holding company, they are larger companies. Anyway, I imagine and I believe that this is how it should happen, that these holding companies are leveraging, they are managing intelligently”, she added.
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In response to these statements from the Health authority, the association issued a statement listing some factors that have them in this situation. First, they point out that “the isapre system records losses of $170 billion in the last 15 months. The underlying problem does not have to do with this figure, but rather with the impediment to correcting this situation caused by the Superintendence of Health by ignoring the regulations issued, only months before, that provide a valid mechanism for calculating price adjustments. Thus, faced with an impossibility of adjusting rates and with rising health costs, fixed and lifetime coverage for members, the Isapres would fall into a permanent deficit, which would inevitably mark the end of the sector.
Second, they warn that “Law 21,350 froze the price of the plans for two years and took away from the isapres the power to adjust the rates, transferring it to the Health Superintendence. This entity calculated the variation of costs in the system, confirmed a rise of 30% and set a 7.6% readjustment limit. The isapres fully complied with the norm, which was later objected by the Superintendency of Health and is now being reviewed by the Supreme Court”.
“As a result of the emergency call that this union has made -they comment in the third point- the highest authority of the Ministry of Health has summoned the isapres to use savings to avoid a forced closure. But if the information of the system since 2018 is considered Until last March, the result is a loss of $ 14 billion. Added to this is that the productive sectors allocate the surpluses to different investments that boost employment, allow the economy and the country to develop, and are not available in an account ” they say
Fourthly, they point out that “as the Minister of Health stated, behind each isapre there is a controlling group that until now has assumed the costs of the system to ensure that it continues to function, however, this figure is not sustainable, given that a permanent financial deficit puts the entire group at risk”.
“We must be blunt: the isapres no longer have an operating margin, today they only work with capital contributions from their owners and the closure can take place in just months. To affirm the opposite is risky, because there are almost three and a half million affiliates involved who listen to calls for calm and who could find themselves, overnight, without health coverage, while Fonasa would have to take in hundreds of thousands of new affiliates in a narrow provider network that maintains long waiting lists”, they affirm.
“We understand that the government is proposing a reform that establishes a single health system that eliminates isapres. But if there is a decision to close the isapres administratively this year, by preventing a price adjustment that allows contractual obligations to be covered, it is important that they report it and explain the impact it would have for the beneficiaries,” they criticize.
Finally, the association hopes “that at the next meeting with Minister Dra. Yarza, at the end of this month, we can inform her in detail about the critical financial situation that afflicts the isapres system.”
