4.3 ASPECTOS LEGALES Medicación. Cobertura. Aspectos legales.

Summary

The video script discusses the complex nature of medication as both a social good and a private right, emphasizing the ethical dilemma between access and distribution justice. It outlines the minimum coverage requirements for medications, highlighting the integral coverage for high-cost drugs exceeding the minimum wage. The script also addresses the importance of disability certificates for full medication coverage and the legal aspects of prescribing off-label or unapproved drugs. Additionally, it covers the social benefits and subsidies available for individuals without social security, the significance of generic prescriptions, and the rights of consumers to substitute medications. The video concludes by stressing the importance of understanding the legal framework to ensure the right to health is effectively exercised.

Takeaways

• 💊 Medications are legally complex goods, considered both as social goods and private rights subject to commercialization and registration.
• 🔄 There's an interplay between the cost of medication, access to it, and the justice in its distribution, which are all crucial considerations.
• 🏥 A minimum 40% coverage for any medication is required, with chronic and prevalent illnesses like hypertension and asthma receiving up to 70% coverage.
• 💰 High-cost medications, defined as those exceeding the minimum wage, must be fully covered to ensure effective access as health is a constitutional right.
• 📄 A disability certificate is pivotal for full medication coverage, especially for conditions like autism, regardless of whether a certificate is presented.
• 🚫 Experimental drugs must be free of charge as per dietary regulations, and coverage for approved drugs is mandatory.
• 📋 The prescription must include the generic name of the medication, but the doctor may specify a brand if there's a justified reason based on their professional experience.
• 🏢 If a medication is approved abroad but not in Argentina, it can be requested for compassionate use, pending ANMAT's approval.
• 💼 Social security, private insurance, and government programs are多层次的 systems that provide varying levels of medication coverage depending on jurisdiction and individual circumstances.
• 🏥 Hospitals' social workers can guide individuals through the process of accessing medication banks and initiating social benefits applications.

Q & A

What are the two main aspects of medicines that influence each other?

Medicines are considered both a social good and a private right subject to commercialization and registration. These two aspects influence each other in terms of access, cost, and justice in distribution.

What is the minimum coverage required for any medicine?

Any medicine must have a minimum coverage of 40 percent.

What conditions qualify for a 70 percent coverage of medicines?

Chronic and prevalent conditions such as thyroidism, hypertension, asthma, and allergies qualify for a 70 percent coverage.

How is the high cost of a medicine determined in relation to the minimum vital and mobile wage?

A medicine is considered high cost if it exceeds the minimum vital and mobile wage, and in such cases, the coverage must be integral.

What is the significance of a disability certificate in terms of medicine coverage?

A disability certificate ensures integral coverage for all medicines related to the pathology diagnosed, whether or not there is a certificate.

What is the condition for a medicine to be covered if it is approved abroad but not yet in Argentina?

If a medicine is approved abroad but not yet in Argentina, it can be brought into the country through compassionate use, provided that ANMAT approval is sought first.

What is the term for a prescription that deviates from the approved dosage or is approved for another diagnosis but deemed applicable by the physician?

Such a prescription is called an off-label prescription and is based on medical professional judgment, backed by studies or analyses.

Why is it important for physicians to prescribe medicines by their generic name?

Physicians are generally required to prescribe by the generic name, which allows for the consumer's right to substitution for a potentially more economical option with the same therapeutic effect.

What is the significance of the decree 987 of 2003 in the context of medicine prescription?

Decree 987 of 2003 regulates the prescription by generic name and allows for justified brand-specific prescriptions when the physician provides a rationale for a specific brand's effectiveness.

What are some of the social benefits and subsidies available to individuals without work social security or prepayment?

Individuals without work social security or prepayment can access various subsidies and programs depending on their jurisdiction, including social benefits related to the province or city they live in.

How does the 'Incluir Salud' program differ from a typical health insurance plan?

The 'Incluir Salud' program is a federal health program that is not a health insurance plan. It provides health coverage to those who receive non-contributory pensions, such as individuals with significant disabilities.