Medical assistance in Panama is divided into two major systems, the Ministry of Health (MINSA) and the Social Security Fund (CSS). Panama has good private hospitals and a range of health plans to support people, but to be served on the public network you need to pay for the state health insurance plan.
The Ministry of Health (MINSA) and the Social Security Fund (CSS) are administratively divided into 14 health regions, with a parallel presence and organized by levels of complexity, offering the population's health services according to their ability to resolve.
It is estimated that 90% of the population has access to health services from either of the two public institutions, regardless of whether or not they are affiliated with social security since there are cross-subsidies between MINSA and the CSS (CSS is estimated to cover 84%).
Panamanian health system health service network
The Panamanian health system has 915 public facilities across the country. Of these, 835 (90%) belong to the Ministry of Health and 80 (10%) to the Social Security Fund. About 212 (23%) first-level care units have at least one basic health team, which in addition to providing intramural care is designed for the community.
The distribution of these infrastructures corresponds to the number of inhabitants in the provinces and regions. However, as we will see later, the human resources associated with the institutions of the health system in Panama are concentrated in the provinces with the greatest wealth and development, which has a negative impact on the health of the populations of the poorest regions and provinces.
Panama's health system human resources
The first objective of PAHO Resolution CSP27 / 10, "Regional human resource goals for health 2007-2015", approved by Panama, states that "all countries in the region will achieve a human resource density ratio of 25 professionals per 10,000 population ".
MINSA has 6,025 general practitioners, 4,059 of whom work in the province of Panama, and 1,966 in the rest of the provinces, while the CSS has 2,914 general practitioners and 1,394 specialists. The sum of these data places the Panama Health System with a density of 29.2 doctors and nurses for every 10,000 inhabitants, according to the most recent Health Statistics Report from the World Health Organization (WHO). However, the situation is uneven in the provinces and counties.
In this sense, it can be said that Panama fulfills (on average) the goal of "25 professionals per 10,000 inhabitants", however, it hides the unfair inequality in the distribution of human resources since these doctors and nurses are concentrated in four provinces (Herrera, Panama, Los Santos, and Chiriquí).
Panama's health institutions should provide medical assistance to those in need, wherever they are. However, the poor distribution of its personnel affects this duty of the State.
The budget of public institutions in the health system of Panama
Despite the amount of money available, deficiencies persist. The scarce health infrastructure (including health personnel and access to medicines and technological supplies), economic and geographic barriers and a weak intercultural approach cause poor access to health services for the indigenous and rural population.
State spending on health is high (7.2% of GDP), but even so, there is also a high percentage of private health spending (30%), which denotes the inefficient management of resources. In other words, many people need to go to the private sector to find solutions. The Health System needs to integrate its services, strengthen management, separate functions, and focus on reducing inequality in access and quality coverage.