The Debt Owed to Health Care

The doctors’ strike did not create Paraguay’s health crisis. It exposed debts that had been accumulating for years. The National Medical Union, led by Dr. Rossana González, called a five-day strike from Aug. 24 to 28 with four concrete demands: a base salary of 8 million guaraníes for doctors who currently earn 5 million net for 12-hour shifts, the appointment of 9,000 contracted doctors out of 12,000, double pay on public holidays, and reliable supplies of medicines and medical equipment.

None of those demands, the column argues, should have surprised the government. A health-care career bill now being offered in haste has existed since 2011. The reduction of working hours from 24 to 12 represents real progress, it says, but salaries remained frozen. Doctors now earn the same amount for half the hours, without a proportional improvement in their working conditions.

The government only came to the negotiating table when hospitals were beginning to lose specialists. The column compares that approach to a firefighter extinguishing fires that officials allowed to grow. It also criticizes the media campaign against doctors during the most intense days of the dispute. Disagreement with the union’s demands or protest methods is legitimate, the writer says, but denying the historic debts behind the strike is not.

Patients bear the cost. They wait for appointments, search for medicines that are unavailable and depend on a public system sustained by professionals whom the state treats as if their work were dispensable. The strike ended without an agreement, and the situation worsened afterward. The union speaks of more than 400 resignations, with projections exceeding 600. By Sept. 5, 270 formal resignations had reportedly been filed with the Ministry, amid accusations that many others were being shelved. At Acosta Ñu, 86% of specialists were reported to have resigned, leaving children without surgeons, anesthesiologists or intensive-care specialists.

President Santiago Peña first referred publicly to the crisis on Sept. 2 through social media, after it had become front-page news, and he did not take part in negotiations. Ministers presented a proposal on Sept. 3, but a Sinamed assembly rejected it unanimously that night. The legislature then tried to fill the gap. Senate President Basilio “Bachi” Núñez announced a crisis committee to work on the 2027 national budget and review public spending.