The bill introduced by the executive last Tuesday not only contains elements to implement the Supreme Court ruling mandating apres to apply the new table of factors to all affiliates and reinstate additional fees, but It also proposes to modernize FONASA by creating a Complementary Coverage Instrument (MCC).
the reason? Account for an increase in contributors, improve financial coverage of all public insurance contributors for use of the free choice modality and provide financial protection to private providers.
To give more details about this proposal, this Monday the Director of FONASA, Camilo Sid, He participated in the Senate Health Commission along with the Minister of Health, Ximena Aguilera, and the Superintendent of Health, Victor Torres.
During its presentation, the CID explained how the new modus operandi would work, which it had given a go-ahead in March itself. This will be a voluntary choice that considers hospital and outpatient services and networks of providers. Which is financed with a statutory health contribution (7%), plus a supplementary flat premium per beneficiary, which will be administered by insurance companies provided by FONASA.
Regarding the financial impact of applying this modality, Cid shows five migration scenarios with a different proportion in each of them, where each population group is randomly selected considering the behavior of the population that is expected from Ispres. shifted to Fonasa. two years.
Assumptions range from 10% of the population living in the private sector to 100% of the population living in Fonasa. And all of them show a positive difference between the income of the contributors and the expenditure generated for the said pension households.
“We have worked with the Ministry of Finance to look at the potential financial impacts and we have looked at a range of scenarios, and they all have a balance or surplus to the possible economic impact that FONASA (…) There is always a positive margin, a surplus but no deficit, regardless of disability benefits, profits or expenditure in administration, otherwise the Treasury would have to finance the people in this manner and that is not the design”. CID explained.
In any case, in place of the consultation, Senator Sergio Gahona (UDI) stated that “if more contributors are going to enter, there will be more fiscal spending and state spending will increase.” But Fonsa’s director again stressed that there is a positive margin in all scenarios analyzed by the Budget Office (Depress). Because those who come from Isapres have 7% more than those from Fonsa”.
The senators also expressed their concern regarding FONASA’s debt to the clinics. The chairman of the instance, Senator Juan Luis Castro (PS), asked the director of the public body if he could elaborate on them.
In this context, the CID assured that “the debt has two components. The debt that we maintained with the clinics at the cut-off date was 4 billion pesos, the outstanding debt because they are the invoices that we have (…) But some people are admitted to the hospital but the challan has not been made. We calculate it anyway and it’s around $90 billion.
During the instance, the directors of Fonasa also denied some of the statements made around the proposal. In this context, he started by saying that “the project leads to monopoly of the state by coercion, it is not so, the project does not encourage change, the change that is happening to the people is within their freedom of choice”. Already some people are picking on Fonasa to make up for the loss of Ispress.
According to the data presented by the authority, since 2020, there has been an increase in migration from Isapress to the public sector. 213,623 people have visited Fonsa during the first quarter of this year.
Cid also addressed the concern of those who say this migration could collapse the public system: “It is clear that what we are doing is changing the financial administrator, nothing happens in the public sector because private People are being served in the area and they will continue to be there.”
Finally, they state that the Isapré migrant population poses a lower health risk than the non-migratory Fonaasa population, which is believed to be the case.