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Overview
The health system in Argentina is made up of three sectors. The Medical Insurance Sector is administered by the trade unions, provincial governments and the autonomous agency responsible for the care of retirees (INSSJP), which together cover about 40% of the total population. In this subsystem “health” is paid between employees and employers. The Private Sector provides health insurance to voluntary members, who pay for it. The Public Sector covers 50% of the population of Argentina that does not have any other coverage, so they fall on this sector to cover their needs. In this case the medical attention is for free.

The top national authority in health is the National Health Ministry (“Ministerio de Salud de la Nación”), which determines the national health policy. However, the provincial governments have full autonomy in public health policy matters, and have most of responsibilities in providing health services. They are responsible for adhering to the national directives. The municipalities are responsible for program implementation and services management in their territory.

What happens if you need to see a doctor?
In the Public Sector where health attention is free, it is necessary to make an appointment with a general practitioner (GP). This is this professional who refers you to a specialist if needed. In general the waiting times for attention in public hospitals is higher than desired. In the Medical Insurance Sector and the Private Sector, you may request an appointment for a general practitioner or for a specialist doctor as you want. The waiting times are much lower than in the Public Sector.

It is very important to clarify that not all public and private hospitals in Argentina have diabetes health services. Generally, private hospitals are better equipped than public hospitals which have the basic equipment. However in both cases there are highly trained professionals.

Who decides what medicines a doctor can prescribe?
The National Administration of Medicines, Food and Medical Technology (ANMAT) is an agency of the National Public Administration. It cooperates in the protection of human health, ensuring that medicines, food and medical devices available to citizens are effective, safe and of good quality. To this end, ANMAT, is responsible for carrying out the processes of authorization, registration, standardization, monitoring and control throughout the nation.

Practically, what is like to live with type 1 diabetes in Argentina?
In Argentina there is a law (N° 26.914) which protects people with diabetes. The law covers 100% of prescribed medications, insulin, test strips and supplies, but not all health insurance comply with it. For this reason, diabetes associations offer advice and guidance on the scope of this law and the rights to health care that people with diabetes have so they can make the appropriate claims.

The lack of information makes type 1 diabetes into a feared disease that nobody understands. As type 2 diabetes is predominant in absolute numbers, it is easy to forget the particular needs and complexity of the treatment of people living with type 1 diabetes. There is so much misinformation that exists. In mass media where a publication of diabetes appears, they always refer to type 2 diabetes, but without clarifying the difference with type 1 diabetes. Like many other places in the world, the majority of the society does not even know that there is more than one type of diabetes.

What about getting admitted to hospital?
When a patient with type 1 diabetes is admitted to a public hospital, they will not pay costs of hospitalization, attention or medication. In the case of an admission in the private or medical insurance sector, they may pay certain costs in accordance with the type of coverage they have.

How does diabetes care vary throughout Argentina?
The differences between national, provincial and municipal regulation generates a particular way of operation and access to health services for people living in different regions of the country. This can mean that there are significant disparities in care, treatment and access.

Diabetes care varies considerably depending on where people live. In the big cities, normally the attention is good, and the access to medication is almost fine. But if that place is small or in a rural area, people with diabetes have greater difficulties in accessing optimal level of care and treatment. If someone has type 1 diabetes and is a child or adolescent their difficulties will increase even more because they may not find specialized pediatricians within hundreds of kilometers from where they live.

Estefanía Malassisi in Argentina provided this excellent information. We are grateful for her help and support.