6
included in the compulsory health plan of the contributive regime (hereinafter
“POS-C”), “they will be covered by a process of insuring them with each EPS”;
(iv) “the beneficiaries of the Court’s judgments” will be exempt from payment
of the financial contribution known as the “moderating quota” when they use
the health care services they require, in accordance with domestic law.
Likewise, they will be exempt from paying “co-payments,” understood as the
“financial contribution corresponding to part of the cost of the service
required”; (v) the victims who are part of the contributive regime must
continue “making their regular contributions to the health system”; (vi)
“identification of each EPS that will be given a program of preferential
attention for beneficiaries of the judgments of the Court”; (vii) creation of a
working team by the Ministry of Social Protection “to train the beneficiaries in
the use of the system,” to supervise and evaluate the provision of the
services, and “to design and measure attention, satisfaction and quality
indicators”;
c) The “prior actions” will be: (i) the precise identification of “the beneficiaries of
the nine judgments,” in order “to carry out a validation with the Affiliates’
Database (hereinafter “BDUA”) in order to detect the population that needs to
be affiliated,” to identify the beneficiaries as “users belonging to ‘preferential
groups’” and to train the EPS in attending to this type of groups; (ii) insurance
coverage according to the situation of “not affiliated,” “affiliated to the
subsidized regime,” “affiliated to the contributive regime,” or “affiliated to a
special regime,” as well as the “harmonization [with the] contributive benefits
plan for those who are affiliated to the subsidized regime”;
d) In order to “use the health care services,” the beneficiary must “request […]
an appointment” and come to the Health Care Institution (hereinafter “IPS”)
for “an initial general examination.” If the beneficiary should require, “the
provision of more complex health care services, he or she must be referred
[…] to the institutions of second and/or third level of care”;
e) For the “provision of emergency health services,” the beneficiary must “go
immediately to the nearest IPS” and, following attention, the beneficiary’s
“affiliation to the system will be verified,” and
f) For treatment of addictions, the beneficiary must “go to the IPS […] for an
initial general examination” and, subsequently, the “EPS […] will determine a
treatment program through specialized institutions.”
12.
On October 3, 2011, the representatives of the victims indicated that “it was not
pertinent […] to submit observations” on the State’s proposal, because it “had not been
approved by the parties and [continues to be] the subject of discussions.” They indicated
that the State’s proposal “does not incorporate progress in the attention to victims; still
contains provisions that increase administrative procedures, […] and reveals difficulties
to ensure access to all the beneficiaries of the measure.”
13.
On January 26, 2012, the Commission indicated “its concern” because “once
again, the State fails to provide information [...] on the differentiated impact on the
beneficiaries of the measure compared to the other users of the social security system,”
as well as the description “of the road map for urgent cases.” The Commission observed
that “it cannot be inferred from the information provided that rapid and immediate
assistance is being provided to the beneficiaries.” In addition, it maintained that “it
appears that the prior diagnoses are not being taken into account,” and that it is unclear
whether “those responsible for the treatment have “the specialization required by each
individual, or group of individuals, personally.” Lastly, it considered that it would be