Ecuador’s Social Security health system gains member confidence; fewer ‘double cover’ with private insurance

Following top to bottom restructuring, massive infusions of cash and a nationwide construction program, Ecuador’s Social Security health care system, part of the Instituto Ecuatoriano de Seguridad Social (IESS), is making believers of many of its members. The government reports that hundreds of thousands covered by the plan are cancelling private insurance coverage they had maintained because of concerns that Social Security would not provide high quality service if they needed it.

The Social Security health system covers both retirees who have paid into it during their working careers, as well as those currently working. In addition, those who are less than 60 years old but who have not contributed, have the option of buying in for about $70 per month.

At least 1,800 North Americans living in Ecuador are covered under the system, including almost 300 in Cuenca. Most of the covered expats have businesses that make monthly Social Security contributions. Several hundred, however, have bought in.

Those who are cancelling private insurance, mostly middle- and upper-middle-class Ecuadorians, say they are using the Social Security plan not only because of overall improvements in service, but because it allows them, in some cases, to use private physicians and hospitals.

Since 2010, Social Secuirty health care has signed agreements with 509 private health care providers, many of them in specialties that are poorly represented within the system.

Another attraction for those who had not used the Social Security plan before, is the guarantee that members can go to any hospital, private or public, in the case of emergency, with the bill being picked up by the government.

Cuenca retiree Catalina Quinde, says the fact she and her husband can go to the nearest hospital in the case of emergency, made the case for her. “This wasn’t true a few years ago and I wasn’t sure about the care I would get at Social Security. Now, I feel good about the system and we’ve dropped our private coverage.” She adds: “It’s good to save the money.”

Quinde also says the service for routine visits to the Social Security hospital and clinics has improved. “When I tried to get an appointment before, it would take a month or two. Now, I can usually see a doctor in less than a week.”

According to the government, the percentage of Social Security members who “double cover” with private insurance has dropped from 60% to less than 30% today. In 2010, according to the Economic Census, 1.3 million Ecuadorians carried private insurance, with most of those also covered by Social Security. The government believes that the number has dropped to less than 800,000 today.

Paul Gonzalez, an administration at IESS in Quito, says he is pleased to see the new confidence in the program. “We have totally restructured, hired the best doctors and installed state of the art equipment. People are seeing and experiencing the progress.”

Gonzalez adds: “Ecuadorians are not accepting the old argument that Social Security can not be trusted and that they need private insurance to protect them. Today, they are beginning to understand that our services are equal to, or superior to those offered by private plans.”

According to Gonzalez, restructuring the system has also required what he calls “personnel housecleaning.” Last month, IESS announced it was firing almost 3,000 employees for engaging in a variety of unethical practices, including theft for resale of medications at hospitals and clinics. “We will not longer tolerate corruption within the system.”

Photo caption: Cuenca’s Social Security hospital