The Panamanian Social Security Fund (CSS) Is in for a Large Shakeup, For the Better

While the past director of Social Security, Enrique Lau, talked about turning Panama into a medical destination, patients tell of the odyssey they have to live through in the public health system. The stories are heartbreaking. “I didn’t know what was happening to me: my legs were swollen, I had gastrointestinal problems and I was vomiting, so I ended up in the Rafael Hernández Emergency Room, where, after a few days, I was diagnosed with chronic kidney disease. That was in 1998. There were very few nephrologists in the country and in Chiriquí there was only one, who moved soon after, so we were left without a doctor.” The Panama government will set up two roundtables to discuss pensions and medical care in the CSS. Two roundtables will work separately: one will analyze the sustainability of the Disability, Old Age and Death program and another will address proposals to improve medical services.

The Panamanian Social Security Fund (CSS) or Caja de Seguro Social Panameña (as it is known in Spanish) is a public institution of the Republic of Panama that is in charge of the planning, control and administration of the contingencies of the social security of Panama. Civil society groups are preparing for roundtable discussions on CSS. Spokespeople for these groups have expressed their optimism regarding the start of the talks and hope that alternatives will be found that respond to the needs of the population. Expectations are mounting among various civil society groups as they prepare for the installation of working tables where key issues related to the Social Security Fund (CSS) will be addressed. Spokespeople for these groups have expressed their optimism regarding the start of the talks and hope that alternatives will be found that respond to the needs of the population. In turn, it was reported that different union and social organizations met over the weekend to unify their proposals and prepare to participate in the working groups. On Thursday, September 12, the President of the Republic, José Raúl Mulino, announced on national television the installation of these tables, which will begin to meet on Monday, September 16, at the Presidency of the Republic. The roundtables will address two major topics:

The future of the CSS Disability, Old Age and Death (IVM) program
Medical benefits, such as drug shortages, surgical delays, improvements in care services, system integration, among others

President Mulino will chair the first meeting, after which sessions will be held every Monday and Wednesday for three hours. At the conclusion of the process, a report will be presented with the results of the discussions. Subsequent meetings will be coordinated by the Minister of Health, Dr. Fernando Boyd Galindo, and the new director of the CSS, Dino Mon. These sessions will last for a month and a half, with the expectation that, after the national holidays, the CSS reform document will be sent to the National Assembly. Roundtable participants will have until October 31 to submit and discuss their proposals. Each proposal must be supported by a financial analysis and a detailed explanation of the source of funding for the proposed model for consideration.

These are the most striking phrases from President Mulino’s announcement on the CSS

“The issue where there are the most complaints is health services. Today the service is inhumane.”
“Medicines are not arriving due to problems that begin with the tender process and continue throughout the entire process.”
“We will not rely on official statistics, but will work with the complaints of those who suffer from the problem.”
“Today, the CSS only has 44% of surgical supplies. This imprudence borders on criminal.”
“Those responsible for this negligence have no valid excuses to justify it.”
“We are going to put an end to waste and recover an institution that is called to take care of the health of Panamanians.”
“The claims are directed at a small group that has profited from speculation.”
“The appointment system is another problem.”
“It is incredible that an institution with 34,717 employees cannot provide a solution to ensure that appointments do not take so long.”
“The first measure proposed by this administration is the unification of the purchasing system through the single purchase program that unifies the CSS and the Ministry of Health.”
“We are coordinating to move the National Oncology Institute to the Health City.”
“Another area we are going to improve is the appointment system so that each patient receives faster care.”
“The Social Security Fund will not be privatized.”
“We will define what we will do going forward with a robust Caja. Rhetoric will not solve anything.”
“The problem with the Disability, Old Age and Death program is money.”
“Participants included in the roundtable have until October 31 to submit proposals and support them.”
“We are going to establish the real debt that the private sector and the public sector have with the CSS.”
“The debts of mayors and districts will be refinanced so that they can be brought up to date.”
“Everyone has to catch up, but the debts must be real.”
“I have recommended to the new director Dino Mon that an online system be established so that each employee can know whether their contributions are up to date.”
“We will request an inventory of all assets to determine the true assets of the CSS.”
“Shutting away from the CSS problem is not sustainable.”
“Once again, I pledge my personal and political support as president of all Panamanians to resolve a problem that concerns us all.”