LEGALIZATION OF THE AMH HEALTH INSURANCE

The employer is legally responsible for the health insurance of his worker. But persons without a permanent occupation, have no chance to obtain a health insurance in Paraguay. For this reason we tried different ways to solve this problem.

At first it was tried to secure the health insurance of the workers with monthly contributions paid by their employers. But it did not work.

In 1993 finally the AMH (Ayuda Mutual Hospitalaria = Mutual Hospital Aid) was started. This system worked as follows: 5% are deducted from the gross income of the Indian, and these 5 percent are then paid to the Medical Insurance. So the employer has to deduct 5% from the salary and additional 10% he has to pay to this Insurance himself.

The only official health insurance in Paraguay is the IPS (Instituto de Previsión Social = Institute of Social Security), which includes health insurance and old age pension. For this insurance the employee/worker has to pay 9% and the employer 16%. But unfortunately the IPS does not accept any casual labourers , but only those with a permanent occupation.

At the present there are 20 insurances for Indians. Each insurance works separately, and about 24.000 Indians are insured in this system. This amounts to 25% of the Indian population of Paraguay and 50% of the Chaco.

The deducted percentage is registered in a workbook and thus serves as an evidence at the health centres of the services rendered by the Indian. This system was based on mutual confidence.

When for the first time two Mennonite deputes came into the Parliament, it was tried to legalize this insurance. But the legalization was not approved. The Paraguayan Constitution provides that other health insurances may be approved, but there is no regulation for this.

But why then is it necessary to legalize the AMH-Insurance?

With the different new tax laws legal receipts are necessary, and the problem is, that the employer has no legal security and, therefore, is responsible for unpaid invoices and receipts he issued for the Indians.

In the meantime each colony made some amendments in the AMH regulations. Therefore, a meeting was held with the AMH Administration and in order to standardize these regulations. The ASCIM was entrusted to work with the legalization. Then these regulations were revised with the employers and the workers.

The FRICC (Federación Regional Indígena del Chaco Central = Regional Indigenous Federation of the Central Chaco) also invited its members and the leaders of the working class districts for a meeting, in which the regulations were revised once more, and then an official application was made to the Deputy Chamber in the Parliament. This time they acted more in accordance with the international agreements. There is an international agreement 169/89, that was approved by the Paraguayan Government as Law 234/93. The article 25 of this law says that the Indians are authorized to organize their own Public Health system.

Las year the Deputies Olga Ferreira de López and Dr. Hans Werner Thielmann announced their visit at the ASCIM for April 15, So a large meeting was organized at Yalve Sange with the leaders of the Indian settlements and the employers. The functioning of the system was explained and the importance of the legalization was stressed. On this meeting a commission was appointed with representatives of the different ethnic groups from the agricultural settlements and the working class districts. Furthermore one representative of the employers of the Government of Boquerón and Presidente Hayes as well as INDI (National Institute of the Indian) were designated. The ASCIM was elected as consultant of this commission.

Unfortunately nobody appeared from the Government of Boquerón or Villa Hayes, and in the meantime INDI .has its third president.

This commission met frequently for the exchange of information. Then the entire AMH-Commission went to the Chamber of Deputies and presented the AMH System to the commissions. The Deputies assured the commission of their support.

A little later the AMT-Project was presented on a plenary meeting of the Chamber of Deputies and approved by majority of votes. Then it was submitted to the Senate. Some preliminary work had been done in the Senate by an interview with Dr. Filizola and the offer to present the project to the different commissions. But unfortunately no use was made of this offer. When we learned that some amendments were proposed, we immediately tried to give the necessary information. A few days before the project was presented on the plenary meeting we were informed that the project would be turned down. Then we tried by all means to speak to some Senators, but with no success. And so the project was entirely rejected.

When reading the arguments made by the Senators, it becomes obvious that they did not study the project at all. Some of the arguments, for example, were:
- They did not want to establish another state bureaucracy.
- It would only cost the state more money.
- It is impossible to have a project like this only for the Chaco.
- In the Senate people talked about "IPS Mau" (illegal Social Security)

Thereupon the AMH-Commission met and defeated these arguments in writing, that was handed over personally to the Senators Dr. Bader Rachid and Dr. Carlos Filizola. Both Senators approved this service rendered by the AMH to the Indian population, and promised their help. Then the law was revised once more by the President of INDI and the Board of the ASCIM. The Chamber of Deputies resolved once more with majority of votes to send the project to the Senate. Now the Senate has a term of 90 days to study the project and this time it can only be turned down if 30 Senators vote against it. We hope that the project will be approved this time. If the answer of the Senate is positive, the project will be sent to the President of the Republic. But since it has to be transformed into a Law, the regulations have to be formulated in detail.

As for the costs we can say that the Boquerón Government pays the tickets to Asunción and the general costs are paid by the ASCIM.

The project would not have made this progress without the active support of the Deputy Dr. Hans Werner Thielmann.

We hope we can conclude this project before the end of this year.

Ing. Agr. Eduard Klassen
Consultant of the AMH-Commission

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