Argentinian accolades
Having begun offering assistance services in the 1970s, Argentina leads the way in Latin America when it comes to helping travellers in need. Alberto Camel Chapur puts the country’s healthcare and assistance market into context
First published in ITIJ 90, July 2008
Having begun offering assistance services in the 1970s, Argentina leads the way in Latin America when it comes to helping travellers in need. Alberto Camel Chapur puts the country’s healthcare and assistance market into context
In the eyes of those who are not familiar with the region, Latin America is often thought of as an entity; perhaps because most of its population is predominantly Spanish-speaking, or because of shared features associated with its Latin lineage. However, Latin America is composed of 42 countries, 21 of which are located in the Caribbean, eight in Central America and 13 in South America. The total population of the region is 560 million, 8.5 per cent of world’s total population. Regarding the socio-political situation in Latin America, the region is democratic, although social inequality and poverty still remain the main challenges in the area.
In this issue, we will focus on Argentina, situated in the far south of America. It has 40 million inhabitants, most of who are descended from Spaniards and Italians. It is the second largest country in South America, after Brazil; the fourth largest in America and eighth largest in the world. The index of human development, level of economic growth and quality of life are all very high.
A nation of keen travellers, and one that receives more than four million visitors each year, it has a well developed assistance industry, and healthcare facilities offering an international standard of care. But what is the uptake of these services, and how well does the system work in practice?
Close to home
The majority of travellers entering Latin American countries do so from within the region. In fact, 59 per cent of arrivals to Latin American countries are from other Latin American countries. Sixteen per cent of arrivals are from Europe – mainly Spain and Italy – ten per cent come from the United Sates and Canada, and the remaining 15 per cent come from Asia.
In 2006, tourism numbers to Argentina reached 4,100,000 – a figure that increased by 11 per cent the following year. The country is the most popular destination for tourists travelling from Chile, Brazil, Uruguay, Spain and Italy, amongst others.
It stands to reason then that travel assistance companies do not also have to be insurance companies
Thus, most people entering Argentina – whether from another Latin American country or from anywhere else in the world – carry with them some form of travel assistance or travel insurance policy. And although these visitors, when coming from outside of Latin America, are generally covered by multinational assistance companies such as AXA Assistance, Europ Assistance, AIG Assist or Mondial Assistance; there are a number of companies that originate in Argentina, such as Cardinal Assistance, Assist-card and Grupo IMAS, which also provide assistance services on a worldwide basis.
As for Latin Americans travelling to other countries, the vast majority of are now aware of the benefits of carrying travel assistance coverage, which has led to substantial growth in the industry over the past few years. Today, over 60 per cent of the travelling population of Latin America is aware of the security provided by medical assistance services, and many now purchase such a policy each time they travel. There is no chamber or association that regulates travel assistance companies in Argentina, so specific data on the country is not available, but companies operating in the country have experienced growth in product sales and have recognised an expanding consumer interest in travel assistance in recent years, reflecting the trend in the wider geographic region.
What’s in a name?
A fundamental difference in the way that trip cover for travellers is offered and provided in Latin America, compared to most other parts of the world, lies in the way such services are rendered. Essentially, Latin American travellers are sold ‘travel assistance’ services, as opposed to ‘travel insurance’ policies: the objective of travel assistance being to provide the service in a direct manner at the moment an event occurs, without the traveller having to pay money; whereas insurance can compel the policyholder to pay costs on the spot, to be later reimbursed. The problem in the latter scenario is that the traveller may not have the money to pay for treatment on the spot. This makes ‘travel assistance’ a more attractive product, and one that is relatively easy to market.
It stands to reason then that travel assistance companies do not also have to be insurance companies. Thus, they are not regulated by government agencies such as the Healthcare Ministry or the Insurance Bureau.
For cultural reasons, many Latin American travellers expect a service similar to the one provided by their pre-paid medicine plan at home when travelling out of country, and they are quite reluctant to accept the differences in medical coverage when travelling abroad. Thus, ‘house calls’ are something Latin Americans often expect to have access to when visiting Europe or the United States.
Assistance products in Argentina are very similar although coverage limits may vary. The limits on a typical worldwide travel assistance product include:
Medical assistance in case of illness or accident: between US$25,000 and US$100,000
Medical expenses for pre-existing conditions: between US$500 and US$1,500
Medical expenses for sports-related accidents: between US$500 and US$1,500
Medication: between US$1,000 and US$3,000
Dental care: up to US$1,500
Most travel assistance companies do provide a rounded product, in that they offer coverage for baggage and legal assistance, as well as medical coverage. Trip cancellation or early return coverage, however, is only available through insurance companies. Typical travel assistance policies also include the provision of medication, dental services, sanitary transfer, and the repatriation of mortal remains. Companies of the calibre of Cardinal Assistance or AIG Travel additionally offer exclusive benefits such as coverage for pre-existing illnesses and sporting accidents, guarantee of return trip, and even a 24-hour helpline
Leading the way
The first travel assistance companies in Argentina opened their doors in the 1970s, and now this industry is well developed. Today, there are around seven local and foreign-owned multinational assistance companies operating in the country. These include: AXA Assistance, Europ Assistance, AIG Assist and Mondial Assistance, together with Cardinal Assistance, Assist-card and Grupo IMAS. These businesses all offer assistance services although only two or three are multi-product and multi-channel companies that also provide roadside assistance and home assistance, amongst others.
in the Latin American region, Argentina, together with Uruguay and Brazil, is a leader in the development of travel assistance services
Thus, in the Latin American region, Argentina, together with Uruguay and Brazil, is a leader in the development of travel assistance services, and as mentioned there is a growing awareness within the country of the need for such cover when venturing abroad. Companies such as Cardinal Assistance and Assist Card have a wide range of products with similar coverage levels as those products found in most advanced European countries.
Along with travel agencies, the Internet is the most popular research tool when planning a trip. Over the last two years, it has also become an increasingly popular channel through which to purchase assistance products – either directly from an assistance company or via a broker. Assistance companies also offer their products through the corporate market, particularly via credit cards, which also generally tie up with insurance companies, HMOs and loyalty clubs.
Caring for health
Although the state’s responsibility for individual sanitary services varies substantially between the countries of Latin America, in general all have adopted measures that ensure universal access to basic medical services. Medical expenses in the region are ‘accessible’ (lower than in the United States, Europe and Asia). Nevertheless, many travellers visiting Latin America, and indeed Argentina, do so bearing a travel insurance policy.
There is an overpopulation of medical doctors in Argentina – three per 1,000 inhabitants – the highest average of any Latin American country, following Cuba. The reason for this is that medicine was one of the few highly regarded university course options provided in the country until a few years ago, when the choice of careers offered through university study was small. Today, most doctors work in both the public and private healthcare sectors.
Argentina has around 160,000 permanent hospital beds, distributed between 1,280 public hospitals and 2,040 private clinics. Fourteen per cent of beds are located in the country’s capital Buenos Aires, a city that accounts for eight per cent of the population. The wider Buenos Aires Province has 48 per cent of beds to take care of 50 per cent of the total population of the country. Cordoba has approximately 12 per cent and Santa Fe has seven per cent of total beds. In the different cities around the country, there are excellent public hospital services, although facilities such as room comfort, décor and catering, are quite deficient.
The private sector, made up of community hospitals (such us the German medical centre, the British and the Italian medical centres), clinics owned by private health companies, and private clinics, in general offer the highest quality of medical services – as in most other countries – as they have greater financial and technical resources.
Overall, the quality of hospital care varies widely amongst different medical institutions and different medical specialties, although there are institutions providing a quality of care comparable to international standards in all specialties, such as cardiovascular and neurological. In Argentina, such institutions treat the same amount of foreign visitors as they do indigenous people.
There is an overpopulation of medical doctors in Argentina
The top private clinics and hospital – such as Hospital Aleman, Anchorena, Sanatorio Otamendi-Miroli, Clinica Suizo Argentina, Sanatorio Agote, Sanatorio Mater Dei, Hospital Britanico, Privado de la Comunidad, Hospital Privado de Cordoba, Hospital Italiano de la Plata, Hospital Español, Sanatorio Allende, and Clinica del Sol – are based in the capital city and in tourist areas like Calafate, Iguazu, Mar del Plata, Cordoba, Bariloche, Mendoza and Salta. All such establishments have plenty of experience in treating foreigners that have some form of travel assistance. In such cases, the cost of care to the assistance company is similar to the price that would be paid by the local population.
The majority of the foreign patients are tourists, although for the last 15 years medical tourism to the country has been increasing – both for cosmetic surgery as well as cardiovascular treatment.