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After analyzing a total of 30 guardianships, the high court unified the rules for accessing health services such as diapers, anti-scab creams and wheelchairs, which previously had to be paid for out of the patients’ own pockets.
The Constitutional Court has just made a decision that will favor those who contribute and are subsidized within the Health Benefits Plan (PBS). With a presentation by justices José Fernando Reyes and Alberto Rojas Ríos, the high court ordered that health services and technologies such as diapers, anti-scab creams and manual drive wheelchairs, be delivered at no cost by Health Providers (EPS ), as long as they are prescribed by the doctor.
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The high court analyzed a total of 30 guardianships that sought to debate the position of the Ministry of Health on some elements that could be obtained at no additional cost. “The citizens maintained that the patients, as well as their families, were people of limited resources and, therefore, could not pay for them on their own. Likewise, they affirmed that health services and technologies guaranteed patients adequate conditions to deal with their ailments, ”the Court explained.
The high court found that there were legal loopholes with respect to some health services and established a rule to make it clear when it is appropriate to request them via guardianship: that “any service and technology that is not expressly excluded, is understood to be included in the PBS.” Under these parameters, the Plenary Chamber made it clear that diapers, as they are not specifically outside the benefit plan, are understood to be included. Thus, they can be delivered at no additional cost, as long as they are ordered by the doctor.
However, if the EPS does not prescribe diapers to a patient in a medical order, this person may access the service through a guardianship action “if a notorious fact is evidenced through the medical history or other evidence attached to the file , due to the lack of sphincter control derived from the ailments that afflict the patient or the inability of the patient to move ”.
Now, if after filing a guardianship, the judge does not find a notorious fact about the need to deliver the diapers, his petition could be protected “in its diagnostic aspect when a protection order is required.” And, said the Constitutional Court, under no circumstances can a person be required to have the economic capacity to authorize diapers by way of guardianship.
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Under those same rules were anti-scab creams, which are elements to reduce irritation and regenerate the skin of patients, and manual drive wheelchairs, which in the market have a price ranging between $ 250,000 and $ 600 one thousand. That is, since they are not expressly excluded from the benefit plan, it is understood that they are included. “The Court reiterated that the right to diagnosis, as an integral component of the fundamental right to health, implies a technical, scientific and timely assessment that clearly defines the patient’s state of health and the medical treatments required,” added the high court. in a press release.
Likewise, on the elements that are excluded in the Health Benefits Plan, the Constitutional Court considered that patients can access wet wipes through a protection action if the absence of the service is recognized as a violation of the rights to life or physical integrity. Such medical input may also be accessed if financial inability to acquire them is demonstrated and, furthermore, if there is no other treatment that may be equally effective within the plan proposed by the Ministry of Health.
