Faced with the impotence of their pockets destroyed by the lack of a salary policy, hundreds of members of private medicine must have felt relief after the Government, in two different ways, promoted a stop to increases in prepaid payments. Added to this is that, if Justice endorses it, a large number of entities
will have to reimburse people for the money
they have been charging above inflation since December. Here are the details about what that refund would be like and what can happen if companies appeal the measure.
The two news items this Wednesday are similar, but not the same. The first was a Government resolution based on a complaint that legislators from the Civic Coalition made to the National Commission for the Defense of Competition. That agency investigated the matter (abusive prices and cartelization of a handful of companies) and decided that seven entities would roll back their dues for six months (until October) to the December value. At most they allow them to apply increases in line with the CPI, the INDEC Consumer Price Index.
In other words, it means that if one paid 100 pesos in December for the Galen, British Hospital, German Hospital, Medifé, Swiss Medical, Omint or Osde fee,
the ceiling of the next bill must remain at 190 pesos
. That is, 100 pesos, plus the inflation accumulated between the last month of 2023 and March (latest official inflation data available).
As for the second novelty, it was a precautionary measure by the Superintendency of Health Services (SSS) against, not 7 but 16 prepaid plans that bring together 91% of those affiliated with private medicine in Argentina. As in the Civic Coalition's complaint, the axis was the presumption of "abusive" commercial conduct, after decree 70/2023 liberalized prices in the sector.
However, the measurements have their differences. The “Super” request not only does not target the same entities (between 7 and 16 in both cases there are only 5 in common) but, while the Executive's resolution ordered the adjustment of the quotas - to the values mentioned - For six months, the Superintendency's protection points to retroactive refunds (that is, everything collected above inflation since December), but does not say anything about what should happen to the fees from now on.
Thus, the Super sets a precedent in a warning tone. As if the Government were telling companies, “
give back what you overcharged until now
,” while suggesting: “
In the future, you are free to charge whatever you want.” But, be careful, we are watching and we are going to ask for another precautionary measure if they cross the line
.”
It is up to the Federal Civil and Commercial Court No. 8 to decide whether or not it gives rise to the protection, processed via a precautionary measure. In the meantime, two things can be expected from that decision.
The first is that, due to the nature of this type of resources and taking into account that in the text presented to Justice, the Super requests
speed and urgency
several times, it is logical that the resolution comes out quickly.
The second is that, in line with what has been happening with different collective protections, there is a good chance that the measure will be accommodated and companies, in effect, will have to return what they were charging above inflation.
How would the return be made?
Prepaid fees and a secret annex of the Superintendency
The Superintendency's precautionary measure includes an annexed document outlining a proposal on
how to complete the return of the money
. It is just a suggestion, which of course, like the entire measure, depends on the disposition of Justice.
The annex was not released by the Superintendency, but government sources explained to
Clarín
what the text says. They clarified that the difference between the CPI of these months and what the prepaid companies were charging practically
reaches 70%
. The proposal, then, was a refund "in easy installments."
Seven consecutive months of repayment, in installments of 9.68% each.
It would start in June and continue until the end of the year
.
As for how it would impact what the affiliate pays, we must remember what was said above: the precautionary measure did not ask the Court to force companies to maintain their future contributions according to any index.
While we begin to talk about a "covert price control" (the opposite of the libertarian imprint), it is deduced that if Super did not make any plans for the future, it is precisely to avoid being left in a complicated (or rather, contradictory) position. Thus, in respect of decree 70, it leaves them the door of freedom to set their prices, but, as suggested by the Government, with that air of "
we are ensuring that they do not set sail
. "
So, if in June companies decide to increase 10%, given that they would have to return 9.68%, the increase in the quota would remain at 0.32%. Now, if inflation drops a lot and companies align themselves with the CPI to avoid more precautionary measures,
the fee could “deflate”
and leave a monthly difference in favor of the member, perhaps to use in the following month's fee.
Faced with nothingness itself, the return of overcharged money is a positive measure. However, in a country with so much inflation, money that is not collected "tomorrow" will have a much lower value than it would have had if it were not collected "yesterday." The Government does not rule out that Justice determines an
inflation adjustment for refunds
.
Surcharges on prepaid medicine fees
It all sounds good, but it is logical to assume that the entities included in the protection will not remain cookie-cutter.
They are OSDE, Swiss Medical, Medicus, Omint, Galeno, Medifé, Hospital Italiano, Obra Social Luis Pasteur, Hominis, Medicina Esencial, Mutual Association of the Hierarchical Staff of National Official Banks, Obra Social Unión Civil Personal de la Nación, Mutual Federada 25 de June, ACA Health, Sancor Health and Prevention Health. Compared to the seven forced by the Government to recalculate the fees, the health plans of the German and British hospitals are missing from this list.
A question that must be asked is what happens if the court grants room for protection, but the entities appeal and the issue is resolved in the immediately higher court, the National Federal Civil and Commercial Chamber.
Juan Bautista Torres López, a lawyer who is an expert in health and human rights (as well as a journalist), explained: “The protection is requested with a precautionary measure and what is intended is to advance the effect of what is to be achieved with the protection, which In itself it is an action whose resolution can take a year, two or more. The precautionary measure in general speeds up the times.”
If the Justice accepts the measure, “it can grant it with a suspensive or refunding effect,” Torres López clarified.
If the counterparty appeals and the effect of the measure is suspensive, “whatever the magistrate determines cannot be executed until it is ratified or modified by the Chamber.” On the other hand, "if it is with devolutive effect,
it can begin to be executed
, without prejudice to what the Chamber says."
The lawyer clarified what is customary in these cases: “In protections for health issues that are processed in the Federal Civil and Commercial jurisdiction, the usual thing is that the protections are granted with devolutionary effect. In other words, the return of money would begin to be executed as soon as the judge defines the issue.”
P.S.
