This is the existential reason for the state, its bodies and institutions, which are inextricably linked with the rights of citizens through the legal system. This serves as a link to the state’s obligation to guarantee rights. Among them, health, education, social security, food and water, which are guaranteed “in particular”, according to Article 3, paragraph 1 of the Constitution, are highlighted by the Constitution. Health services are managed according to the principles of fairness, solidarity, quality, efficiency, etc., according to Article 32 of the Supreme Law. Older adults are guaranteed “free access to medicines”; women to “health services for mothers” (Art. 43 No. 2). The Constitution is full of health proclamations.

The hospital in Quito has the first national center for fetal medicine and surgery in Ecuador

The state, therefore, has the obligation to make the guarantee of rights a reality, especially those it guarantees “in particular”. I will focus on health. Health services are perhaps the worst of the public services under the jurisdiction of the state. Their “management model” could not be worse. You don’t need to get involved, the results are visible. The Ministry of Health and the Ecuadorian Social Security Institute (IESS) regularly owe dialysis entities; They owe extraordinary sums to the Charity Committee of Guayaquil and Solca. Since they do not have a hospital infrastructure, they have to refer patients to private hospitals and clinics that pay for their services.

The new government is challenged to make a remarkable turnaround in the management model of public health services.

Considering the objective tragedy of public health, it is urgently necessary to make a 180-degree turn. It is obvious that the management control of public hospitals, with some exceptions, is a disaster. The procurement of medicines in various government hospitals seems to be conducted according to the guiding principles of stupidity and negligence. A large number of health users enables dizzyingly clear planning of work, reduction of costs due to the size of purchases and a clear definition of an effective control system. In the Charity Committee, you never hear about dramas in their services. On the contrary, it helps the state. Then copy their way of working!

In addition to the latest purchases of equipment for health centers and hospitals, the Ministry is preparing a transition report for the government of Daniel Nobo

A scheme of private participation in the provision of public health services must be devised that enables the state not only to provide services, but also to acquire infrastructure funded by individuals and maintained by individuals. This is not “privatization”. The state does not lose any property, but would gain property. Consider that currently many private hospitals and clinics provide some health services in large quantities due to the inadequacy of the state. An urgent new approach to public health must banish ideology and politics. We are fed up with political cannibalism and failures in the management of various public services. The new government is challenged to make an extraordinary turnaround in the management model of public health services. We need to dive deeper into the analysis of this model to change it where necessary. (OR)