Atención gerenciada

La reforma silenciosa

Abstract

Managed care works as a silent institutional process in the reform of medical social security systems. In many cases it generates contradictory and conflicting re-articulations between macro-political and micro-political processes and among neoliberal project followers. The demantling of the medical social security system in Argentina is a paradigmatic example of how the policies of the World Bank and its allied governments favor the introduction of multinational financement in the health system. Managed care operates as a silent ñinstituyenteÑ on the medical social security (provides health care) reform. In many cases it generates contradictory and conflicting rearticulations between processes macro and micropolitics, and among the own defenders of the neoliberal project. The deregulation of the medical social security in Argentina is a paradigm example of the World Bankís policies and its allied governments, to favor the introduction of the multinational financial capital in the health system.__!It is important to analyse the case of Argentina, because the medical social security system (called “social works”) manages a high percentage of the total health budget and also because the unions that control most social security institutions are already enroled in the implementation of policies developed by the World Bank and executed by the Argentina Government. Managed care organisations and insurance companies based in the United States, are acquiring a protagonic role in the implementation of those policies. These organisations take advantage of ‘empty spaces’ in new legislations in Argentina, becoming managers of social security funds.