Escribo este artículo en parte superado como un chileno particular, víctima ante “uno de los mejores sistemas de salud del mundo”. La frase, bastante famosa ya, corresponde al ex ministro de salud Jaime Mañalich quien dijo sin ningún atisbo de vergüenza que: “Nuestro sistema de salud es uno de los mejores y más eficientes del planeta”. Esto fue publicado por El Mostrador el 21 noviembre de 2019.
Cuento esta situación a consciencia de ser un privilegiado y extrapolando las variables a propósito. Y ese es un aspecto central en esto; si yo, que tengo las posibilidades y los recursos sufro esta industria de la salud siendo parte de un 16% de cotizantes de isapres, la verdad es que me complico mucho cuando pienso en gente vulnerable, como será para ellos la experiencia brutal de ser parte de este sistema.
En estos tiempos de pandemia, hay procesos críticos que ya son de un nivel altísimo de complejidad, pero que, en este escenario, se vuelven insosteniblemente críticos. Tuve la mala ocurrencia -involuntaria, por cierto- de tener un problema de salud un poco complicado para este ciclo. Pero la salud no se programa, sucede.
Tuve cálculos -una roca en tu riñón- y luego cólicos -la arenilla se desliza por la ureta-, con un dolor insoportable que me derivó de urgencia a la clínica. Ese paso, con uso de isapre incluida y gastos asociados, fue por si solo de un aproximado de $400.000. Aunque fuera en un lugar caro relativo, ese valor por esa atención es comparable al costo de ese paso en ciudades como New York, Tokio o Singapur. O sea, lo caro acá en Chile es igual o más caro que la misma atención en las ciudades más caras del mundo. Me parece una contradicción en sí misma en un sistema que se implementó con el propósito de democratizar el acceso a la salud. Aunque sea el falso sentido, el que se publica para la galería, no el que se habla de verdad en esas reuniones secretas a puertas cerradas donde muy pocas personas definen el futuro de millones.
A los días, fui al doctor especialista, urólogo. Menos mal me tocó un doctor real, porque me ha pasado ser recibido por unos con tan poca empatía o voluntad que uno se cuestiona cómo llegaron a ejercer. Debo reconocer que yo en los centros de salud me pongo nervioso, muy incómodo, quizás me salgo a lo irracional y necesito en ese momento un cable a tierra.
El médico me revisó y no definió nada, ni proyectó nada y fue una tremenda decepción en ese aspecto. También quizás por propio funcionamiento de la mente se me hace fácil avanza cuando el paso posterior concluye, pero no me funciona avanzar ante vacíos. No esperaba que el doctor resolviera, pero si que me pudiera indicar con claridad a que iba todo eso que me estaba pasando, pero, así como los Carabineros no tienen suficiente educación, los médicos no tienen ninguna instrucción social/comercial para atender a sus pacientes como corresponde a estos tiempos, tanto en planos culturales o sociales en un mundo digitalizados donde la tecnología es una diferencia clave.
Solo me despachó con una lista de 9 exámenes por hacer que me explicó un poco, pero que no entendí. Los problemas para poder realizarlos han sido una sumatoria de adversidad con los escasos permisos como protagonistas (porque los permisos de salud son lo mismo que los de compras, lo que limita y encierra tu actuar. O sea, debo decidir entre comer o atenderme); una vez fui para hacerme uno de los exámenes y el centro estaba cerrado a pesar de que públicamente debía estar abierto, en otra ocasión me hice un examen y me lo rechazaron por no seguir las instrucciones ¡pero nadie te dice las instrucciones! Una de las cosas más importantes del periodismo y que muchas veces la audiencia no comprende ni por asomo, es que nos enseñan que uno debe escribir hasta para un analfabeto. Para que hasta el poco preparado pueda entender las palabras que escribes. ¿No debería haber un punto ahí en la salud para que si te mandan un examen que se debe cumplir bajo estricto reglamento de condiciones venir con un breve instructivo? Me parece tan lógico, pero uno es el loco por andar pensando cosas así.
Luego, hice averiguaciones y llamé a los distintos insoportables medios de contacto para preguntar detalles de los exámenes y entre doctores, la isapre y los centros, me dieron información hasta contradictoria. Yo quería saber si tenían un orden de importancia, un orden temporal o causa efecto, o como tomarlos de la mejor manera, pero me sentí como el único ser preguntando por esas cosas. Francamente la atención al teléfono de las ejecutivas tanto de la isapre como de los centros de salud, fue negligente y además; frías, toscas y cortantes. Como que les molestó que yo anduviera haciendo preguntas. Claro, hay que volver a causar la consciencia a modo pandemia. Me gusta aprender y saber, pero acá parece que los de esa vereda no quieren que los de ésta nos enteremos de ciertas cosas. No se explica que hay algunos exámenes de los que no puedo encontrar referencias en Internet, mientras hay otros que por una letra de diferencia es otra la medición. Esto en contexto de comprar los bonos ¿cómo puedo comprar el bono correcto o incluso, hacerme el examen correcto? ¿Estos exámenes no son más o menos universales? ¿Por qué no tienen un cierto estándar informativo mínimo para que el paciente pueda conocer más del tema? Es como si la industria estuviera a favor de la ignorancia de su contraparte. Hablando de salud, parece ser una premisa malvada. También le pregunté al doc por dos síntomas relacionados que me pasaban y su respuesta fue en ambos casos derivarme a otros expertos. Yo puedo estar atendiendo a un cliente por sus dudas sobre RRSS, pero si me pregunta por una campaña en prensa no cuesta mucho un comentario por ahí más allá de derivarlo de inmediato, y por automasia, a otro profesional. Ser una guía es gratis.
Y así miraba las órdenes médicas, y aún impresas son tan precarias, tan limitadas y tan ordinarias que no dicen nada más que un término inentendible. Y un factor de identificación; un código que ni el sistema de la isapre ni Google reconoce como tal. Anda a buscar ese término o código en los buscadores de la isapre -la herramienta ofrecida para ello- porque no encuentras ninguno a primeras. O sea, acá además hay que ser un verdadero Sherlock Holmes para resolver cual es el examen concreto que necesito.
Retomando el tema financiero, además calculé el monto de los exámenes para saber cuánto me costaría todo eso en dinero. Y haciéndome todos los exámenes en los lugares más baratos posibles -asumiendo con ello lejanías en distancias urbanas- valoricé el total en un rango de los 100 mil pesos. Si, sin pega desde mayo y a punta de ayudas, el sistema contempla que uno puede hacer movimientos de este tipo. Eso raya en lo utópico. En lo que no es posible. Y esa cifra sin contemplar que después se vendría otra hora al doc y posiblemente acciones o medicinas posteriores que suman costos.
Entremedio, el doctor -y en esto solo caben agradecimientos y es ejemplo de una posición diferenciadora a sus pares- me dio su correo. Y en un intercambio me repite que el daño puede ser irreparable para mi riñón. Lo que no es una máxima que me active, sinceramente, paraliza más. Si el doc me dice algo así, pero mi acción es concreta para solucionar es bastante entendible, pero si te dicen algo así en todo este embrollo, creo que los efectos no son tan positivos. Al menos a mí, me dan ganas de mandar todo al carajo.
Con todos estos antecedentes, mi proceso de salud se ve absolutamente comprometido. No es un tema de criterio ni de responsabilidad. Tengo absoluta consciencia que debería resolver estos temas como corresponde. Pero frente a esta experiencia, no tengo ninguna motivación por resolver un problema que se me hace inentendible, en un trayecto tan obstaculizado como confuso.
A mi parece y lo diré muy en simple, el sistema de salud completo es una industria precaria, mal desarrollada, con escasa voluntad de los médicos o instituciones, y que en su aspecto más dañino no ha contemplado a quienes recibirán la atención. Está hecho para personas, pero sin considerarlas en el plan realmente. Tampoco esta industria ofrece una reciprocidad válida, no hay trabajo de comunicación ni canales apropiados para recurrir a las instancias -ni las privadas, ni las estatales- ni las que supuestamente se han hecho para esto objetivos.
La apreciación que me queda es que es carísima e inclemente, en forma y fondo, una paradoja vital; la salud en Chile es intratable.
Si te gustó este artículo, ¡compártelo! ¡Gracias!
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