Private clinics in severe crisis due to falling consultations and income

Desperate calls, “massive” teleconferences, pleas to the banks and insistent efforts before the national government. The timing of clinics, sanatoriums, private hospitals and diagnostic centers is critical and unsustainable, including those in Córdoba, of course.

Overnight, on March 19, patients disappeared from consultations, medical practices were minimized, and treatments were left unfinished for fear of contracting Covid-19.

To make matters worse, many health centers “cleaned” their hospitalizations to receive infected with coronavirus that, fortunately from the health point of view, never came. But that caused an economic impact that must now be faced.

The panorama extends to independent doctors and health professionals, that is, those who are not employees of health establishments, work with single-tax and in some cases rent clinics.

The fall in the demand for health is crossed by a sharp adjustment in the fixed costs of the activity. The so-called hospital supplies doubled or tripled their value since the outbreak of the pandemic. The best known are the chinstraps and gloves, but everything went up in price for an elevator.

The crisis in Córdoba and in the rest of the country is monitored daily through teleconferences of the Association of Clinics, Sanatoriums and Private Hospitals (Adecra) that works together with Cedim, an entity that brings together diagnostic and treatment companies. The Argentine Health Union (UAS) congregates all of them.

Some Cordovan people participate in these tables, such as Pablo Paltrinieri, administrator of the Private hospital, and Marcos Lozada, his counterpart at the Allende sanatorium.

The large health institutions came out in April to seek low-rate bank credit to sustain their turn, but now they need, as explained in the UAS, that the State take over the payment of at least 50 percent of the salaries of the personal through ATP. More than 300 thousand Cuil are those that require this contribution throughout the country. The number at stake is tremendous.

Today, an agreement could be reached with the Fatsa union federation to establish the bases for personnel suspensions with a 25% salary reduction for services that are paralyzed.

Instant collapse

Paltrinieri did not walk around to explain the situation. “It is not the same as a tsunami when you find yourself standing or kneeling. And he found us on his knees, ”he told The voice.

“In minutes, the drop in activity that remunerates these services was brutal,” he said. In April, the clinics lost at least 60 percent of their income. Most paid salaries with consultations and practices billed to social works at the beginning of the year, since they take between 60 and 90 days to take effect.

But others, almost all say in the sector, had to resort to bank credit, even with the possibility of being left out of the subsidized rate of 24 percent that had a limit of 400 direct workers. It was the case of the Oulton institute, which awaits definitions to take the next steps, said its head, Carlos Oulton.

The larger the size, the more important is the weight of the fixed costs. El Privado, with 1,700 employees, plus a thousand doctors, obtained this financial assistance.

Lozada points out that in Allende the outpatient consultation was reduced to 15% and hospitalizations to 25%. “With what is billed today you can not pay anything,” he said. It has two thousand payrolls to meet monthly.

Hard to unravel

As follows? No one knows because a question that is currently unanswered hangs in the air: “How long will it take for people to return to the clinic?” Asked Paltrinieri.

Oulton was especially critical at that point. “We are going to be covered by the coronavirus but other conditions are going to be much more complicated with a result in lives that can be similar,” he warned. This is because the patients stopped doing what in the environment is called the “screening”Of their pathologies, that is, anticipating the evolution of diseases through specific studies and treatments.

For Oulton, without ending the mandatory quarantine, it is very difficult to visualize a path of recovery from activity and even then the return of the patients would demand time that the structures need to sustain financially.

Small outpatient health centers with doctor’s offices and some minimal practices (analysis laboratory, for example) were also left with no room for maneuver to cope with the situation: they operate at 10 percent of their usual regimen.

“The patients that we did not take care of in March, April, we did not take care of them anymore. We will not recover that billing. Salaries are fixed, oblivious to any possibility of maneuvering. Income, also, deadlines are arranged by social works, “said Eduardo Novillo, administrator of the Villa Allende Model Center for Medical Specialties.

To these costs must be added inputs, and in many cases the rents of large structures, particularly in the center of Córdoba.

Telemedicine, a door ajar

With empty corridors, clinics and sanitariums, telemedicine appears as “a new world” to explore, Eduardo Novillo points out. In some, patients can take turns for medical consultations that way. In this exchange, the doctor determines if personal assistance is required, in which case the shift and the safe-conduct are generated to move. But not all providers have the same chances of billing from that door that begins to open because the property belongs to the platform.

Debt of the Nation hits a home in Córdoba

The State’s debt with institutions dedicated to serving people with disabilities has a correlation also in Córdoba.

Yesterday the situation of the Hogar El Sol, located in Malvinas Argentinas, was discovered, which despite accumulating claims on the Nation and the Province that are beginning to be millionaires, is going through a desperate day to day process to provide assistance to the 48 young people with an average age 26 years old.

Ivana Rosetto, head of that center, indicated that they work with the Prosad and Profe-Include Health programs, which have had a debt since September and February last year, respectively, to date.

“With marked insistence, the corresponding claims have been made, but silence was the only response. Legal measures have been taken before Family Counselors of the Fifth Shift, judicial notices of intimation on this situation were carried out by the intervening judges, but we always obtained silence in response, “the directive explained to The voice.

The situation not only affects the acquisition of the basic and essential supplies to serve the 40 inmates and eight outsiders, who attend schools, but also determined a wage delay that impacts workers.

These go through real hardships in their personal situation as supporters of the home and also in basic matters such as not having the resources to move to El Sol.

Rosetto was especially emphatic in the discrimination verified by these therapeutic centers. “There is money but clearly addressed from the Nation,” he said. At this point, the debts to the home begin to turn out to be millions, since each month of delay implies about 600 thousand pesos. It is added that from Prosad they request again and again the presentation of documentation already delivered in a timely manner, which is exhausting.