La privatización del sistema de salud no es la respuesta a los problemas en Honduras, sino, políticas orientadas a buscar lo que tienen en común Canadá y Finlandia: calidad de vida, economías florecientes, tasas de desempleo bajas, niveles educativos elevados y una tasa de corrupción muy debajo de la media.

El sistema de salud que se impulsa en Honduras se presta para corrupción gubernamental, haciendo fácil el drenaje de fondos en contubernio con los empresarios de la salud. En otras palabras, un sistema óptimo para que se dé un “Saqueo del IHSS versión 2.0.”

Oscar Efraín Sánchez Sura* / EL LIBERTADOR 

Recientemente, el gobierno ha tenido que lidiar con el descontento de la nación debido a los escándalos de corrupción, sumados a una larga lista de actividades sospechosas y flujos irregulares de capital. Los escándalos del IHSS, del INE, la irregularidad de las patrullas, y la pírrica forma de operar de las instituciones de justicia, producto de la politización por parte del gobierno, entre otras.

Ahora, a un gobierno con cada vez menos credibilidad, se le suma una crisis de salud cada vez mas profunda. La ciudadanía está renuente a aceptar que se suplante el modelo publico por un nuevo modelo, el cual sin muchos rodeos, trata de descentralizar y privatizar el sistema de salud nacional, además de intentar centralizar el plan de jubilaciones de la ciudadanía, de por si escéptica ante el hecho de que de que el gobierno maneje los fondos pensionarios, por su historial de corrupción en el INJUPEMP.

La ciudadanía se ha manifestado en contra de la propuesta de plan de salud que el gobierno esta tratando de implantar, en el que se pretende que las empresas proveedoras de salud (EPS) sean las que encargada de brindar los servicios de salud. Este sistema no es nuevo ya que Colombia lo tiene implementado. Según la OMS (2010) el sistema colombiano está ubicado en el puesto 22 a nivel mundial, y muchos lo apoyan por el hecho de haber aumentado su cobertura al noventa por ciento. Con una cifra así, de primera instancia, es lógico preguntarse, ¿porque no? 

En realidad las preguntas deberían ser: ¿Como están los indicadores de salud? ¿Cuál es el índice de mortalidad materna? ¿Cual es la tasa de mortalidad infantil? Si revisamos las cifras del Banco Mundial (2013), la tasa de mortalidad materna colombiana es el doble de la tasa reportada en Vietnam, un país asiático, pobre y sin recursos. A su vez Canadá, un país con medicina socializada reporta apenas la séptima parte de Colombia. Y si hay todavía escepticismo, al revisar la tasa de mortalidad infantil colombiana, es similar a la de El Salvador, un país con una realidad bastante similar a la nuestra, mientras países nórdicos como Finlandia, donde la medicina es casi completamente gratuita, reporta la sexta parte en comparación a Colombia. 

En el momento de revisar dichas estadísticas te preguntas: ¿Cuál es la magia de la privatización en salud? ¿Realmente es la privatización en salud y la exclusividad de atención de las EPS la respuesta a nuestro problema? La conclusión es redundante. Se puede ver que la privatización del sistema de salud no es la respuesta, sino, lo que tienen en común Canadá y Finlandia: calidad de vida, libre mercado, economías florecientes, tasas de desempleo bajas, niveles educativos elevados y una tasa de corrupción muy debajo de la media. Esa es la solución no solo a la problemática en salud, sino a toda la gama de problemas que aquejan a la ciudadanía hondureña en estos momentos. 

Y por si esto fuera poco, la opinión de los colombianos es en general, negativa, manifestando que los servicios no solamente son mas costosos sino cada vez mas ineficientes, aunado lógicamente, a que las EPS pertenecientes a las aseguradoras intentan ahorrar en lugar de brindarle el tratamiento optimo al paciente. En el caso de que el gobierno cubra los costos, las EPS inflan las facturas, recetando medicamentos innecesarios y realizando exámenes de laboratorio cuyos costos son exuberantes, para diagnosticar padecimientos que pueden ser manejados y diagnosticados con exámenes más sencillos y baratos. 

Dicho sistema se presta para corrupción gubernamental haciendo fácil el drenaje de fondos en contubernio con los empresarios de la salud. En otras palabras, un sistema optimo para que se dé un “Saqueo del IHSS versión 2.0.” Solo dos conclusiones mutuamente excluyentes se desprenden de estos hechos: o bien el gobierno es sumamente ineficiente para analizar que los modelos de salud socializados son los mejores en el ranking mundial, y en su lugar implementa un modelo que no se encuentra entre los mejores 20 y con múltiples fallas, o por el contrario, la medida fue sumamente bien pensada e ideada para continuar con el drenaje de fondos del estado. 

¿Como es posible que el gobierno intente privatizar e incrementar las facturas de atención en salud a una ciudadanía cada vez más pobre en la que la clase media está desapareciendo? Ante eso, la ciudadanía hondureña se ha expresado en contra de implantar un sistema de salud que no se ajusta a su realidad nacional, pero su contraparte, (el gobierno) hace oídos sordos a las exigencias de esa ciudadanía. 

Esto, exacerba aun mas la problemática de la crisis nacional incrementando la inconformidad colectiva, que se ha demostrado no solamente con antorchas. En las últimas dos marchas la ciudadanía sampedrana se ha encargado de brindar donativos, módicos, pero significativos para los mas necesitados, dándole una bofetada al gobierno al expresar con dicha acción el descontento en referencia al sistema de salud. 

Tegucigalpa se unió a la iniciativa y se entregó, en la última marcha, donativos al Hospital Escuela Universitario con la finalidad de darles un respiro a los pacientes que necesitan de una mano amiga. No me sorprendería ver que otras marchas a nivel nacional muestren una conducta similar de desaprobación al gobierno y demostrarle que no van a permitir que acabe con el sistema de salud público.

Menos me sorprendería que ante un eventual colapso de salud la ciudadanía se organice y ejecute un sistema de salud público alterno, con pequeñas clínicas gratuitas y/o brigadas medicas con médicos voluntarios, el cual sea operado por todos los estratos de la sociedad, como recurso humano voluntario, así como donativos de la misma sociedad civil, ONG, organizaciones internacionales, y otras naciones hermanas identificadas con el pueblo hondureño.

No tengo duda que el pueblo hondureño llegará a esas instancias, a pesar de la oposición de algunos sectores sociales que alegan que las ayudas solidarias son incorrectas y no deben realizarse porque no se debe solucionar el problema al gobierno. Aunque respeto esa perspectiva, pienso que no será la intención del pueblo solucionar un problema gubernamental, sino un problema que el gobierno le ocasiono a la misma ciudadanía y que lógicamente, es la más afectada por sus actos irregulares. 

Se sabe de antemano, que con un pequeño donativo no se salvará el sistema de salud, pero al menos si se salvara la vida de un compatriota, y en la medida de lo posible, mejorará su calidad de vida. El pueblo hondureño empieza a dar los primeros pasos en desatender las decisiones gubernamentales en pro de la desobediencia civil, y empieza a demostrarlo con estos hechos, por lo que surge entonces una serie de preguntas: Si la ciudadanía está actuando por su cuenta y dejando al margen al gobierno, ¿entonces para qué está el gobierno? ¿Para qué sirve un gobierno si no esta representando la voluntad de la ciudadanía a la que se debe? ¿Adonde queda el gobierno?  No cabe duda que la ciudadanía responde a las mismas: El gobierno esta quedando al margen. Por esa razón, no sorprende que la ciudadanía clame colectivamente todos los viernes y sábados: ¡Fuera JOH!

*Hondureño y doctor en Ciencias Médicas y Sociales.

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