The mystery is resolved in parts. The expenses of the Ecuadorian Institute of Social Security (IESS) begin to show their affiliates. The information on hiring external providers, which was elusive in previous administrations, comes to light and shows the dependence that insurance has on private medical centers.
Between 2013 and 2018, Social Security hired 880 private medical providers. That is, health houses to cover the demand for care that members have. For these services, the institute paid 3,418 million dollars. More than 3% of the Gross Domestic Product (GDP) of Ecuador.
In the last three years of the government of former President Rafael Correa, more agreements were signed with the private sector. In 2015, a record of 724.5 million dollars was reached for services in that sector.
The data draws attention because, in those years, public works were also inaugurated to reduce attention in private hands.
Moreover, in March 2016, former President Correa questioned payments to private providers. In a Saturday even asked “why the central government has to pay for the health care of retirees?”.
The need for private support for medical care is most evident in Guayas. In the analyzed years, 1,604 million dollars were allocated for 143 providers from that province.
The analysis also shows that the Charity Board of Guayaquil has been the main partner of the IESS in recent years. 526 million dollars went to the organization between 2013 and 2018.
In second place is the Society for the Fight against Cancer (Solca). The entity, which also questioned Correa in 2016, was awarded 117.2 million dollars. The third place is also from Guayas: the Kennedy Clinic Hospital signed agreements with social insurance for more than 111.3 million dollars.
The current president of the Board of IESS, Manolo Rodas, ordered that the information be published so that citizens know how much and to whom they pay for hospital and outpatient care throughout the country.
The order will also allow the names of those hired by the Social Security Institute to be transparent to avoid inconveniences such as those exposed on August 4 by EXPRESO. The Office of the Comptroller General of the State found that nine El Oro medical contractors did not have the permits to provide health services.
When asked about this, the IESS authorities explained that there is still no official notification of the DNAI-AI-0464-2018 report approved by the Comptroller on July 5 of this year. However, they announced that once said notification “immediate compliance with the recommendations contained in the report will be available.”
The audit observations, they recalled, “should be applied immediately and with the character of mandatory; they will be monitored and their non-compliance will be sanctioned by the Comptroller General of the State.“
Among the list of irregularities that the control body found in its report -which reviewed compliance with recommendations during the previous government- is also the inadequate management of medicines, the lack of timely payments and little attention to the improvement of health systems information technology in the IESS and all its branches.
Contracts fall in the last year
After 2015, the Ecuadorian Institute of Social Security (IESS) reduced the signing of contracts with private medical providers for the inauguration of works. In the list are, according to a communiqué of the institute, four general hospitals, four maternal centers for children and thirteen medical units of the Rural Social Security.
According to Social Security, “the detailed publication of the investment in the health service is an action within its transparency policy and demonstrates the level of sustainability and responsibility with which the IESS manages the funds”.
A purchase of $ 533 million
The transparency tool published by the Ecuadorian Institute of Social Security (IESS) shows, in addition to contracts with private health providers, the expenses incurred in the purchase of medicines. Between 2016 and 2018, social insurance paid 533.1 million dollars to 698 suppliers for medicines.
Quifatex, Novartis, RRP Golden Integra Importadora, Leterago del Ecuador, Pfizer, Medicam Health Solutions, Ginsberg Ecuador, Merck Sharp and Dohme, JRC Pharma Group and Grünenthal Ecuatoriana are the main suppliers.
In May of this year, the IESS signed payment agreements with the main providers of medical services.
The information on contracts, amounts and providers is public on the IESS website: www.iess.gob.ec
The IESS, in 2017 and 2018, reduced the hiring of external services for the inauguration of hospitals and other centers. (I)