Reservations regarding proposal to decentralize health care
SD. Entities with some participation in the health sector, as well as specialists in the area, were in agreement yesterday in their support of the President's initiative to once again submit the legislative proposal that would create the National Health Service (SNS).
The legislation stipulates the creation of the Coordinator of the National Health Service (CSNS) as a public, autonomous and decentralized agency, assigned to Public Health, and with an executive director. It foresees for the SNS a budgetary transference from the Central Government, the health administrators and other services.
"With the creation of the National Health Service and the Regional Health Services, as proposed by the legislative initiative, a giant step will be taken with regard to the access of health services, and allowing the state to focus the economic resources destined to the health sector in a more efficient manner," said Fernando Caamaño in a press release from the Superintendant of Health and Labor Risks (Sisalril).
The director of the Dominican Medical College (CMD), Amarilis Herrera, recalled that the SNS is mandated by the General Health Law (42-01) and the Dominican Social Security System Law (87-01) which visualize the decentralization of the health services.
"What they are looking for is that they stop charging the recovery quota in the public services and that the administrators of health risks (a sort of HMO) have to pay for the service that are give the patients that are insured," she said.
"If you talk to me about having an independent budget, well this also implies a greater expenditure of the health budget and a greater bureaucracy," she said.
Although he agrees with Herrera regarding the need of the SNS, the Social Security specialist, Doctor Fulgencio Severino does not share the division of health service into regions, as contemplated in the proposal.
"The fundamental problem when the services are regionalized is that when it comes time to assign the resources, they are assigned according to the population density, and then those regions that have less population density receive fewer resources....and also the regions and the provinces are very politicized and we would not want the selection of the human resources in the health field to become politicized," he said.
Severino also criticized that the legislative proposal does not make it clear as to who will appoint the personnel of the Regional Health facilities and he feels that there are other aspect that are unfinished and need to be cleared up in the future.
The legislation stipulates the creation of the Coordinator of the National Health Service (CSNS) as a public, autonomous and decentralized agency, assigned to Public Health, and with an executive director. It foresees for the SNS a budgetary transference from the Central Government, the health administrators and other services.
"With the creation of the National Health Service and the Regional Health Services, as proposed by the legislative initiative, a giant step will be taken with regard to the access of health services, and allowing the state to focus the economic resources destined to the health sector in a more efficient manner," said Fernando Caamaño in a press release from the Superintendant of Health and Labor Risks (Sisalril).
The director of the Dominican Medical College (CMD), Amarilis Herrera, recalled that the SNS is mandated by the General Health Law (42-01) and the Dominican Social Security System Law (87-01) which visualize the decentralization of the health services.
"What they are looking for is that they stop charging the recovery quota in the public services and that the administrators of health risks (a sort of HMO) have to pay for the service that are give the patients that are insured," she said.
"If you talk to me about having an independent budget, well this also implies a greater expenditure of the health budget and a greater bureaucracy," she said.
Although he agrees with Herrera regarding the need of the SNS, the Social Security specialist, Doctor Fulgencio Severino does not share the division of health service into regions, as contemplated in the proposal.
"The fundamental problem when the services are regionalized is that when it comes time to assign the resources, they are assigned according to the population density, and then those regions that have less population density receive fewer resources....and also the regions and the provinces are very politicized and we would not want the selection of the human resources in the health field to become politicized," he said.
Severino also criticized that the legislative proposal does not make it clear as to who will appoint the personnel of the Regional Health facilities and he feels that there are other aspect that are unfinished and need to be cleared up in the future.
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