‘Financial suffocation’: Argentine medics fear the consequences of Milei’s chainsaw cuts

TGarrahan Children’s Hospital in Buenos Aires is teeming with patients, parents and medical staff. Families stand shoulder to shoulder waiting for appointments as staff race between dozens of operating rooms. In wards decorated with cartoon characters, mothers and fathers rest with their cheeks on those of their children.

The Garrahan treats more than 125,000 patients annually, including 40% of Argentina’s pediatric cancer patients. 70% of children with complex congenital heart defects. It also performs 50% of pediatric organ transplants.

But despite being the largest and most important children’s hospital in the country, doctors and nurses now fear for its survival. Medical workers say they are facing “financial suffocation” that threatens to have a devastating impact on the quality of care, and they have organized protest marches to draw attention to the dire financial situation of the public health sector.

“It is becoming impossible to continue to provide the quality of care that patients deserve,” said Mercedes Méndez, a 60-year-old palliative care nurse.

Argentina has been struggling with deep-seated economic problems for decades; it suffers from some of the highest inflation rates in the world and is the International Monetary Fund’s largest debtor. In response, nearly 56% of the electorate voted for wildcard candidate Javier Milei, a self-described “anarcho-capitalist” and libertarian economist, as president last year.

Since his inauguration in December 2023, Milei, who campaigned on promises to bring a chainsaw to the state, has implemented a major austerity measure, slashing government spending, laying off thousands of civil servants and freezing budgets.

Although the budget for the Garrahan has not been reduced, staff say the cost savings are still impacting services. In one example, they said unfilled delivery orders have forced surgeons to resort to decades-old surgical techniques, while in another they said medications given to outpatients were being rationed. Garrahan Hospital denied both allegations.

Several staff warned that the decline in living conditions and a reduction in real wages would push a significant number of people out of social security and prepaid health insurance, “overburdening” the public health system.

“It is the most vulnerable people who come to our hospital. And there are now more and more of them because people no longer have social security,” says Méndez. In September it was reported that the national poverty rate had risen to 52.9% in the first half of the year.

A neurosurgeon, who spoke on condition of anonymity for fear of reprisals, said patients now had to choose between “coming to hospital or eating”. “We have to see patients with tumors, for example, every three months. But we are losing that control because people, especially those who may live 2,000 kilometers away, cannot afford the plane or bus tickets,” he said.

Employees also fear that economic problems are starting to affect healthcare. Alejandro Lipcovich, a hospital administrator and union leader, said outpatient medications had recently been restricted and staff had complained about supplies in the operating room.

The neurosurgeon said he recently had to perform surgeries without absorbable plates and screws, which are used for bone fixation, because labor was delayed.

“The absorbable screws and plates that we use in craniofacial surgery have not been paid for, so in some cases we have had to resort to surgical techniques that we have not used for 10 to 15 years,” he said. “It’s completely safe, but we haven’t had to do that in over a decade.”

Such surgeries are time-sensitive and if delayed, they can lead to cognitive problems in a child’s brain development, the neurosurgeon explained. “At first we kept saying it was just a postponement, but we waited and waited and couldn’t wait any longer,” he said. The Department of Health and Garrahan denied any deliveries had been missed or not fulfilled.

Employees also said that due to annual inflation – which in October 2024 reached 193% – their salaries have actually been devalued “by half”.

“The problems started seven years ago, but last year, with the transition of the government, they got dramatically worse,” said Dr. Pedro Núñez, an emergency department doctor. “We have lost 50% of our purchasing power since December, and although inflation has stabilized (slowing to 2.7% monthly in October), we are still four steps ahead.”

The neurosurgeon said the salary loss was felt most acutely by nurses, pharmacists and technicians, adding: “Most of them now earn below the poverty line.”

Some hospital workers said they earned less than what was needed to pay for the family’s basic food basket, despite regularly working 12-hour days and being on call 24 hours a day.

The neurosurgeon is afraid that the hospital will soon have to deal with an exodus of staff. In response to Milei’s slogan ‘there is no money’, the surgeon said: ‘Argentina has economic problems, yes, but there is money. This is a political decision.”

Analysis by the Argentine Association for Budget and Public Financial Administration shows that inflation-adjusted government spending fell by almost 30% in 2024 compared to 2023, while total health spending fell by 20%. Guido Rangugni, vice president of the association, said funding for the treatment of chronic diseases fell by 60% and that of sexually transmitted diseases by 82%.

Diego Alonso, the director of the Foundation for Health Research and Management, an NGO, said his analysis shows that prices of vaccines and medicines have increased by more than 300% since December 2023. “This has subsequently led to a decline in HIV, sexual and reproductive health programs, oncology and viral hepatitis, among others,” he said.

The Health Ministry said the salary increases were in line with those of the “rest of the national public administration” and that the public health system had been in a “state of emergency” for 22 years in a row. It said national hospital budgets, immunization programmes, procurement of medicines and supplies, and funding for vulnerable sectors are “guaranteed”.

Garrahan Hospital said the quality of care is “assured”, there has been no rationing of outpatient medicines and staff losses are comparable to previous years. Asked whether it would handle salary complaints, the hospital said it would not answer questions about employees’ personal records of income and expenses, and denied that staff lived below the poverty line. It was also said that the number of patients had not increased.

Hospital workers say they will continue to protest the critical financial situation of the public healthcare system. However, the neurosurgeon said: “We don’t have much hope. This government does not want to listen.”