Tuesday, February 12, 2013

Health Care in Chile

Auge plan There are a number of high-mortality pathological conditions (currently 69[5]) that have special guarantees for both Isapre and Fonasa affiliates. The Auge (from the Spanish Acceso Universal con Garantías Explícitas, "Universal Access with Explicit Guarantees") or Ges (Garantías Explícitas en Salud, "Explicit Guarantees in Healthcare") plan includes four guarantees in relation to these illnesses:[4] Access: individuals will be able to get attention from a network of providers near their place of residence, Opportunity: there is a maximum pre-established time limit to get attention (both initial attention and after the diagnosis), Quality: services will follow technical requirement standards that will be established based on medical evidence, and Financial coverage: payment to providers cannot be an obstacle to attention. There will be a maximum copayment of 20% of the cost, with the total not to exceed one month of income for the family in a year. [ "Few people realize that end stage renal disease is a disease for which we have universal coverage, irrespective of your age right here in the United States... The principle of covering everyone for serious diseases is already well established...  one way we could have had universal health insurance in this country was to extend the number of organs covered.  Imagine if we covered the heart and the liver".

Victor Rodwin - Professor of Health Policy and Management Robert F. Wagner Graduate School of Public Service New York University

"The composite rate is intended to cover all operating and capital costs that efficient providers would incur in furnishing dialysis in outpatient facilities or in beneficiaries' homes. The base composite rate as of 2006 is $130 for freestanding dialysis facilities. Medicare caps its payments to facilities at an amount equal to three dialysis sessions per week. Although home dialysis may be given more frequently it is not fully reimbursed by Medicare." Wikipedia - End Stage Renal Disease Program

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