a teacher living in a city where the gastronomy workers' Obra Social provided better care than the teachers union's Obra Social could not freely switch plans even when it would have been in their best interest. This was mended in the year 2000 when National Decree 446/2000 was signed into law which established changes to the regulation of Obras Sociales, allowing for workers to choose freely between Obras Sociales administered by different workers unions (although they are still obligated to adhere to one of the Obras and make regular payments). Private sector The private health care sector in Argentina is characterized by great heterogeneity and is made up of a great number of fragmented entities and small networks; it consists of over 200 organizations and covers approximately 2 million Argentines. Private insurance often overlaps with other forms of health care coverage, making it difficult to estimate the degree to which beneficiaries are dependent on the public and private sectors. According to a 2000 report by the IRBC, foreign competition has increased in Argentina’s private sector, with Swiss, American and other Latin American health care providers entering the market in recent years. This has been accompanied by little formal regulation. Public system A system of public medical facilities is maintained by the government. The public system is highly decentralized, as it is administered at the provincial level; often primary care will be regulated autonomously by each city. Since 2001, the number of Argentines relying on public services has seen an increase. According to 2000 figures, 37.4% of Argentines had no health insurance, 48.8% were covered by Obras Sociales, 8.6% had private insurance plans, and 3.8% were covered by both Obras Sociales and private insurance schemes. Currently, about half of the population uses the public system. Health Policies Patients need to apply for free care at public institutions and undergo a lengthy test in which they may be rejected at some hospitals. The rejection rate is usually 30-40%. Public hospitals in Argentina who have not converted to managed care principles are facing an influx of patients covered by privatized social security funds. Public hospitals in the city of Buenos Aires reported about 1.25 million outpatient visits by patients covered by the privately administered social security fund for retired person. The Provincial and Municipal Health Secretariats and Social works through the Superintendence of Health Services are in charge of allocation of resources and