Santo Domingo.– The former director of the National Health Insurance (SeNaSa), Pink Chanelstated that the state Health Risk Administrator is going through a technical bankruptcyas a result of the fraud that affected the services offered to thousands of members throughout the country.
Rosa explained that the 2024 preliminary financial statementspublished last Friday, reveal that For every peso in assets that SeNaSa owns, the institution owes two pesoswhich means that, if all your assets are liquidated, you could only cover half of your commitments with doctors, clinics, pharmacies and other service providers.
“That, technically, is known as bankruptcy,” said the former official, although he clarified that SeNaSa will not go bankruptbecause the Government has decided inject resources from the National Budget to guarantee the continuity of services.
He also indicated that several of the contracts that caused the financial crisis have been suspended by the current administrationand highlighted that in the Last three months the state ARS has closed its financial years in positiveso the losses correspond to a accumulated debtestimated at around RD$26 billion.
The alerts come from 2021
Rosa recalled that since the year 2021 began to warn of worrying signs within the institution, initially not linked to finances, but to loss of quality management system that guaranteed services to members.
Interviewed on the El Mañanero Program, he pointed out that the profile of some people appointed to key positions did not correspond to the functionswhich caused failures in internal processes.
Added to this was the delay in payments to service providerswhen previously SeNaSa strictly complied with monthly payments.
Failed controls
The former director also questioned the financial reporting system, stating that for years the states sent to the Superintendence of Health and Occupational Risks (Sisalril) They did not reflect the financial reality of the institution.
He cited as an example that in the recent financial statements there appear more than RD$9,000 million in expenses and debts that did not appear in previous reportsdespite the fact that the State has sufficient control mechanisms to detect these irregularities.
Impact on affiliates
Rosa recognized that the crisis has generated uncertainty among membersespecially those who have been exhausted or denied coverage for medications and procedures, which directly affects patients with chronic diseases.
However, he called on the population to maintain trust in SeNaSaremembering that the Government has reiterated that no member will be left behind and that the institution continues to operate with more than 7,000 service providers nationwide.
He explained that not all coverage denials are due to the financial crisis, but many respond to certain procedures are not included in the Health Services Plan (PDSS) approved by the National Social Security Council.
Regain trust
Chanel Rosa stated that SeNaSa will recoverconsidering that the crisis was conjunctural and not structural, and urged the current management to identify cases where acquired rights were violated to restore coverage affected by fraud.
“SeNaSa is the main instrument of social protection of the Dominican State. Confidence in the institution must be restored, not destroyed.”
