ASUNCIÓN – The Paraguayan government's proposed 2026 national budget (PGN) is facing criticism, with many arguing that the health sector's budget allocation is woefully inadequate to resolve the country's structural crisis. Calls for a comprehensive reform of the national healthcare system are growing, particularly due to a lack of transparency and pervasive corruption.

During a recent public forum hosted by the civic group 'Me Sumo Diálogo Ciudadano,' economists, healthcare professionals, and citizens unanimously agreed that Paraguay's current healthcare system suffers from a triple threat: corruption, fragmentation, and underinvestment. They criticized the practice of determining the budget "behind closed doors" and called for a more transparent budget-making process that includes citizen participation.

Economist Verónica Serafini highlighted the complexity of the health budget, noting that funds are scattered across various agencies, not just the Ministry of Health, leading to inefficient management. She specifically criticized the practice of "outsourcing," where public investment is replaced by millions of dollars in contracts with private entities. For instance, the Paraguayan Social Security Institute (IPS) signed a $50 million contract for diagnostic imaging services, an example of how a substantial amount of the budget is being funneled to external providers.

The Perception That "Health Is an Expense, Not an Investment" 

Serafini pointed out that the 2026 Ministry of Health budget accounts for only 2.5% of the gross domestic product (GDP) and 6.8% of the total national budget. This falls significantly short of the 6% of GDP minimum recommended by international organizations.

Comparing this to Uruguay, which invests 9.5% of its GDP in healthcare, she posed the fundamental question, "Why can't Paraguay do the same?" Doctors exposed the harsh reality of dilapidated hospital conditions and a lack of basic medicines, accusing the budget of becoming "fuel for corruption." Dr. Rosana González of the National Union of Physicians emphasized that "health is an investment, not a cost," criticizing the government's complacent attitude.

Growing Citizen Burden Amidst a Chronic Crisis 

The combination of low public investment and system inefficiency is directly burdening citizens. According to Serafini’s analysis, out-of-pocket healthcare costs borne by households have surged from 12% in 2017 to 17% in 2024. For women, this figure is even higher at 21%. This indicates that the failing public health system is exacerbating social inequality in access to medical services.

Dr. Ignacio Iramain, a pediatrician and senator, pointed to system fragmentation and poor management, urging for a complete redesign of the healthcare system and a real increase in per capita health spending. Experts have a pessimistic outlook, concluding that this budget proposal, while showing a numerical increase, fails to bring about the fundamental changes needed to solve the country's structural issues.

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