He also said evidence that there are medicines that hospitals charge them up to 30 times more expensive. “A 30 milligrams Dexivant box with 15 pills costs the equivalent of 737 pesos public price.”
“I have 12 evidence of people who, due to a gastric treatment in a private hospital in Mexico City, another in Monterrey and another in the city of San Luis Potosí, paid 30 times” by not covering it insurance.
“How is it possible that if you hired medical expenses insurance, today you see yourself in the need to still pay a medical cost, a medication extra cost and an extraction of care utensils?” He questioned.
Transparency
Since neither the insured know what they are entitled to propose that it is mandatory to make public the network of medical services, hospitals, doctors and doctors.
Today insurance users complain that “they do not know what right they have, what hospitals go, what doctors can be based on their specialty and what guarantees of payment they will have when they leave their medical procedure.”
End to hospital “ kidnapping ”
Although it is already prohibited, there are hospitals that retain patients and even babies until medical insurance pays.
“But no hospital can retain you, today we see hospitals that retain newborns, the body of deceased people or they don’t let you out after 18 hours that the doctor is registered until he pays insurance. For what purpose?, To put another hospital room night, ”says the PRI.
In 2004 the section of 1994 was removed from the section that allowed to retain in guarantee in the hospitals and today article 230 of the Federal Criminal Code says that no human being can be retained due to lack of payment in any health institution, but that It is not fulfilled.
The solution is to force insurance to be those who must guarantee payment and patients have no responsibility, they go home.
“If there is an expense that is not covered by a preexistence or any issue, we agree. If you do not have medical expenses insurance and arrive at a private institution and want to assist you there by individual decision and you will pay your money, you will have to sign a promissory note and retire and have the payment obligation, ”says the legislator.
Pre -existing diseases
In case of pre -existing disease in Mexico they are not covered. But in many insurance in the world there is an alternative: the reimbursement perhaps not 100 percent of the value of the total condition, but a part.
“We are considering that they give you up to 3% of what the policy can cost,” Abramo said.
If the policy is 10 million pesos, three percent would be about 300 thousand pesos, a resource with which the person can attend to that evil that does not cover the insurance.
New regulatory body
Abramo Masso recalled that in 2021 the Economic Competition Commission (Cofece) acknowledged that there is a contubernio in the private health sector “to be inflating” prices.
The Attorney General’s Office of the Consuming (Profeco) also evidenced it in 2019 ”and today it is time that nobody does anything” so it decided to propose the package.
It proposes that there be a regulatory body that can supervise a case -by -case case, that the rates of medical expenses can not upload year more than inflation year.
Portability of medical insurance
He also proposes that the insured can choose the transfer of his insurance according to the benefits they offer
That will encourage competition by preferring insurance with better benefits, faster service, a more agile payment.
“Today if you want to change you give you portability sanctions” and if the change is given there are services that are not covered, for example when insurance is changed “no insurance will guarantee at least two years that you can give To light in another insurer, he will not pay it. ”
Those things are what we are going to prevent, because in other countries they are guaranteed portability.
Who is who in insurance?
The PRI proposes that the qualification that insurers are based on the qualification given by their users to be published transparently and month by month.
“If the insurer does not have good customer service, he does not pay time, mistreats him, he puts it in the last place in the row, he will have a negative rating and will help patients to change with the insurer who guarantees best service,” He explained.
