An everyday scene in the Argerich Hospital guard, filmed surreptitiously, has exposed a phenomenon that was talked about in a low voice, but of which there was no documentary record.: More and more Buenos Aires residents are forced to leave the province to seek medical attention.
In just a minute and a half, the video reveals a reality without makeup or story: A doctor sees the guard overwhelmed and goes to the waiting room, where the delays for care already exceed four or five hours. He tries to explain that Argerich’s resources are limited and are aimed at serving residents of the city and, in particular, La Boca. “Where do you come from?” the professional asks the patients waiting in line. The responses were all from cities or towns in the province of Buenos Aires: At payment, Florencio Varela, Aldo Bonzi – The Best Of Aldo Bonzi (The slaughter), Avellaneda, Espadrilles y Zapiola.
Would anyone have imagined just a few years ago that a neighbor of At payment Would you go to a hospital far from your city? It was exactly the other way around: La Plata, with a hospital network that knew how to be of excellence, was historically a pole of attraction for patients from throughout the province and from the interior of the country. Today, however, instead of attracting, it expels. We must, then, call things by their name: there is a kind of Buenos Aires exile, forced by increasingly degraded public benefits.
Buenos Aires public health has collapsed: the guards are collapsed, there are many services who were left without specialists, getting a medical appointment is an odyssey and IOMA coverage (the provincial State’s social work) is increasingly precarious. Added to this are the deterioration of hospital infrastructure and equipment and a structural crisis that also affects the private medicine system.
The confidential surveys carried out by medical associations among their members show devastating results: More than 80 percent of doctors are dissatisfied with the conditions in which they practice their profession. To achieve a survival income, a doctor today has to resign himself to a scheme of multiple employment, caring for one patient after another and fulfilling on-call duties in establishments that operate on the verge of saturation and collapse. This is reflected in another alarming fact: the private health system today works with 30 percent fewer doctors than four years ago, according to an estimate by the Chamber of Health Providers of the Conurbano (Capresco). Many professionals have gone to work in neighboring countries, where they charge up to eight times more for an on-call, a delivery or a surgery.
IOMA, meanwhile, offers a chilling example of the collapse of the health system in the province. Managed by a La Cámpora activist who graduated as a doctor in Cuba, it has dismantled the traditional coverage system to create its own care network through an obscure and questioned system of its own polyclinics. The result has been catastrophic: today IOMA has cut its coverage, to the point that there are municipalities, such as St nicolas, who decided to leave that social work and hire private coverage for municipal agents. Last month, Mar del Plata affiliates tried to take over the IOMA offices, fed up with not receiving answers. The social work accumulates a debt with the Provincial Medical Federation of more than 2,500 million pesos and has delays of more than six months with pharmacists. Members encounter clinics and professionals all the time who suspend care due to IOMA. In Tandilmore than 25,000 people were left without coverage.
Health is – along with education – one of the areas in which the abyss that exists between reality and discourse is most clearly exposed. The Buenos Aires government cultivates a rhetoric based on the slogan of the “Present State” and boasts of a “public investment” that, however, does not translate into quality benefits, but rather into a fattening of the state apparatus that, at the same time, weakens and deteriorates its essential services. The equation, whichever way you look at it, exhibits gross distortions: the Kicillof administration has incorporated, in four years, at least 47,000 public employees. But at the La Plata Children’s Hospital there is a lack of nurses and pediatricians. There are administrative offices in which there are between two or three employees for each chair or desk. That means that if they all went to work one day, they would have nowhere to sit. As? Don’t they always go to work? In many agencies of the Buenos Aires State, “optional work” has been naturalized.
It is paradoxical: in the name of the State, public resources are squandered, essential services deteriorate, the hospital system is broken and an unequal culture is fostered in which the doctor on duty is underpaid and overwhelmed while the rented militancy is paid without going to work. This is part of a general context of degradation in Buenos Aires, in which the public school is subordinated to union logic, while crime and mafia organizations advance on the cities.
“What has grown the most in La Plata in the last four years?”asks, before a small audience, a business leader with a long experience in the capital of Buenos Aires: an industrial park?; any commercial activity? a real estate development? Nobody got it right. What had the greatest expansion was the “megatake” of The Ovens, a land usurpation that spread at a dizzying pace to the point of becoming “the largest seizure in the country.” Hand in hand with this phenomenon of urban marginality, clandestine trade organizations that colonized the main squares of the capital city have also grown. Everything has happened with the complicity and protection of the State. In front of the government itself, Kicillof has consented to a large illegal fair that operates under the diffuse alibi of “the popular economy.”
In this landscape, the provincial Legislature blends in, a symbol of profound institutional degradation. which has only deserved the scandalous silence of the entire Buenos Aires political system.
That province governed with ideologism and incompetence, with hollow slogans and dialectical alibis, begins to expel the people of Buenos Aires. They are “silent exiles” that pass below the statistical radars, but are increasingly evident: many take the Roca railway to receive care in Buenos Aires hospitals, while others go from IOMA to a prepaid one. Thousands of families move from cities to gated communities in search of safety, or migrate from public schools to private education to ensure classes are taught. Others go to look for work or work in the Federal Capital or other provinces, if not directly to another country. They are citizens who flee from different forms of helplessness and who assume a kind of exile or internal migration in search of the most basic things: security, health, education, employment.
Buenos Aires, which was historically a receptive province, today is an impoverished territory that expels its citizens. It also does the same with investments, which find friendlier environments in other provinces with less tax pressure and governments less hostile to business culture. The tourism industry has had a much more vigorous and innovative development in Mendoza, Jujuy and Patagonia than in the interior of Buenos Aires. The industrial belt of Córdoba has registered, in recent years, a much greater expansion than that of the suburbs, where the private employment rate has been, at best, stagnant. Agricultural investment itself has begun to look for other destinations, even in neighboring countries such as Paraguay, while the knowledge industry has registered, in the Buenos Aires ecosystem, much less development than it promised just a decade ago.
The video of the Argerich doctor who asks “where do you come from?” could be just the tip of the iceberg. It shows a kind of Buenos Aires exodus, which is usually the result of governments that know how to spend and collect, but do not care about managing. They are regimes that only believe in their own ideological stories while denying management, and that assimilate quality, demand and efficiency with the ideas of “the right” and “mercantilism.” Behind those pompous slogans, reality begins to emerge: more and more Buenos Aires residents are going to look elsewhere for what the Province does not give them.