Fragmentation is a common trait of most Latin-American systems. In Argentina the lack of integration among sub systems has a deep impact on health care access and financial sustainability, leading to exclusion, inefficiency, inequality, lack of transparency in administration and one of the highest burdens of household catastrophic out-of-pocket spending in Latin America. The national budget, although within the average of the region, is insufficient to cover the health care needs of the uninsured and to fully address the imbalances in social determinants of health. In this article, we first present the organizational and financial structure of the health care system. We then analyse the system dynamics and local health care history, and we explore a few possible lines of action and reforms for the next decade. This analysis may provide lessons for other countries in the region with analogous contexts and facing similar challenges.