In modern terms, Peru’s healthcare system was largely underdeveloped for many years; but the economic fortune that Peru has experienced in more recent years has allowed for a significant overhaul and reform of the system.
However, the road to health reform is rocky. Peruvian Congressman Gustavo Rondón, secretary for the Committee on Health and Population, notes that the budget for healthcare in Peru is one of the lowest in Latin America. “As such, we must prioritize investment in this area efficiently. Peru often gets ahead of itself with technological developments or innovation, while we still need to implement the basics. We become idealists; we want the latest technology, but in reality that will only reach a few people. That is one of the failures of Peru’s health reform. We should be more practical than theoretical by putting norms into practice and allocating more personnel and equipment.”
One of the key goals of Peru’s Ministry of Health is to now provide universal health coverage for all Peruvians by 2021. Leading the charge in this endeavor is Pedro Grillo, chief of Seguro Integral de Salud (SIS), the public health insurance agency run by the Ministry of Health that provides access to basic health services to unemployed Peruvians and those unable to pay for social security or private insurance. Between 2011 and today, the number of affiliates associated with SIS has increased from 12 million to 15 million, nearly half of Peru’s entire population, in part due to increased funding for the agency. With 25 percent of the population without any access to social protection today, there is still a great deal of work to be done to ensure that universal coverage is reached.
Grillo has an immense weight on his shoulders to not only ensure universal coverage but to guarantee that the system is sustainable to maintain this coverage by improving the infrastructure, services and security of Peru’s public health institutions. “To introduce the process of universal insurance reform in Peru, we must revise our benefit plans to suit the needs of our policyholders,” Grillo stresses. “We have introduced a performance-based model exchange with other public institutions such as public hospitals and regional health facilities. We also exchange services with social security provider EsSalud and we purchase services to private providers of health services, in order to grow our supply base for our members.”
This exchange of services is particularly important as many of Peru’s hospitals are often overcrowded and over-managed. Gustavo Ambrosini, general manager of Fresenius Medical Care Peru, points out that in addition to leveling income among physicians, stronger supervision of health service delivery and general streamlining, health reform strongly accounts for interchangeability. “In the past, patients were limited only to hospitals of EsSalud or the Ministry of Health depending on their insurance status,” recalls Ambrosini. “Now the government is trying to combine hospitals. This could be a good idea and is a faster solution for the lack of infrastructure. But there are mixed points of view about this. EsSalud and Ministry of Heath hospitals are already packed; bringing more people could make things worse, but if the government constructs more hospitals it will be a good thing. The idea will certainly collapse unless additional infrastructure is built.”
The Ministry of Health announced a USD 3.5 billion investment in infrastructure projects in November 2014, aimed at revamping old hospitals with crumbling infrastructure and building up to 50 new hospitals within five years. This investment has received mix opinions among various stakeholders, but certainly provides good opportunities for the private sector, including companies like Fresenius. “I believe this strategy is excellent for the country,” concludes Ambrosini. “ProInversión has a very favorable image in Peru. If a country does not have sufficient infrastructure and government approval is slow while the private sector is ready to invest, build and operate, this is undoubtedly a good thing.”
“We are now starting to see brand new public health centers pop up across the country, in places like Piura, Chiclayo, Tumbes, Cuzco, Arequipa or Tacna,” states Carolina López-Torres, general manager of Hospira Peru. “Consequently, I think we can compete with other Latin American hospitals, given this fantastic infrastructure. This is great news for us and for industry; now is the moment to invest and support the sector. The Ministry of Health has many projects and capital to build hospitals; the government has finally come to the realization that they must have an agreement with the industry because it is unsuitable for them to administer everything themselves. Contracts with foreign companies with more experienced can be very beneficial. In my position, it is critical to be the first to get our type of products to these hospitals.”
Article written by Cameron Rochette