The push for UHC: A breakthrough for patients in Argentina

Tuesday, 7 June 2016

The Ministry of Health for Argentina has recently passed a law in support of Universal Health Coverage. Isabel Rolando, President of Concebir, explores what this means for patients in Argentina today.

Concebir was founded 20 years ago and has been a member of the International Alliance of Patients' Organizations since the Global Patients Congress in Budapest in 2007. We have worked mainly on patient-centred healthcare providing support and information to others through workshops, seminars and campaigns for Fertility Care.

Through these years we have fought for Universal Health Coverage, for the coverage and regulation of Assisted Human Reproduction Techniques (ART), so that everybody can have access to treatment, as a right to life and to have a family.

Our 2013 breakthrough

We achieved a national law for the coverage of Assisted Reproductive Technology (National Law 26862), in June 2013, not only for infertile couples, but also as a wider reproductive right, including single mothers by choice and same sex partners. Based on patient-centred healthcare, we conducted workshops for reflection on information, management and good doctor-patient relationships, highlighting the patient as an integral part of healthcare.

Reaching the nation through the Ministry of Health

This year the Ministry of Health for Argentina incorporated the Law into their national programs. It is a major breakthrough for the region. Dr Jorge Lemus, Health Minister, said:

“Universal Health Coverage seeks that all individuals, especially the most vulnerable, have access to quality services they need throughout their life cycle, whether that is information, prevention, treatment, rehabilitation or palliative care, without going through financial difficulties to pay for them.

Its main objectives are to achieve the maximum possible level of health, addressing the social determinants of health, achieving equity, coverage, accessibility, sustainability and solidarity of the system, ensuring the quality, timeliness and continuity of services."

The Minister announced that Universal Health Coverage was established in Resolution 475/2016, published in the Official Journal of the Federal Health Council (COFESA).

Ongoing challenges

Thanks to this development at the state level, we started working with a team from the Ministry on the Assisted Reproduction Programme, because unfortunately the law is sometimes misinterpreted by health insurance companies.

For example, there is no 100% coverage for medication, cryopreservation and subsequent embryo transfer. The law provides for coverage of three trials of Assisted High Complexity Fertilisation in full but some health providers do not follow this, and consider the freeze and subsequent embryo transfer as a complete attempt in itself. This is not full coverage, and in many cases egg or sperm donation is not covered either.

We must therefore continue to work towards this through the Superintendence of Health Services, an entity created to deal with claims for breach of law. It is the result of the poor drafting of the Regulatory Decree where those issues are not tacitly specified, and of which we ask for correction.

Another hindrance is that the state didn’t implement it in public hospitals, except for some in the Province of Buenos Aires (through the Buenos Aires Law 14028), which today adhere to the national act.

Still some way to go

For all this there are still people who cannot have a family, which is a constitutional right in our country, because some provinces do not adhere to the National Law. It is discriminatory to have different standards within the same country.

There is still some way to go. The new Civil Code, enacted in August 2015, gives us rights such as the creation of a Donor Registry, payment for egg and sperm donors, clarity on the fate of frozen embryos, and refers to compliance to existing laws with a new one.

That law would close the loop between the cover provided and Reproductive Rights, which was preliminarily approved in the Chamber of Deputies in November 2014 and must be reviewed by the Senate, which until today has not happened despite the encouragement of medical institutions and NGOs. Today it will be possible thanks to the Program of Universal Health Coverage.

The creation of a new network

In Argentina, we created the first network of gamete donation families in Latin America. Families D Network was created in order to establish a link of continuous exchange between all those who, for various reasons, use ART to have their children. The goal is to exchange experiences, doubts, fears, resolutions, anecdotes and more from pregnancy through the various stages of raising our children.

In November 2012 we founded RedTRAScender, the Latin American Network of Organizations of infertile people, in Santiago, Chile. The founding members are the following NGOs: AMI (Mexico), Concebir (Argentina) and Queremos Ser Padres (Chile). Other organizations joined from Peru, Brazil, Colombia, Uruguay and Costa Rica, representing patients and carrying out actions in Latin America.

Working together is of paramount importance to achieve the goal of forming a family thanks to access to information, respect, good medical and doctor-patient relationships and specialized medical teams to guarantee patient-centred healthcare!