Due to different factors in the sustainability of the Colombian health system, households today are spending more resources on health, since only in the first quarter of this year, The indicator was already above 5.1%, being after recreation and culture the highest rate in what Colombians buy for themselves.
(See: What are health actors asking for to solve the current crisis in the system?)
Precisely, one of the largest expenses that system users are having is on Voluntary Health Plans (PVS), that is, complementary, prepaid plans, ambulances and health policies. Well, according to data from the Superintendence of Health and Fasecolda, analyzed by Acemi, On average from 2020 to 2024, spending on these plans has increased by 68%.
Also, It is expected that this year alone, sales for this concept will reach $12.5 billion. When disaggregated from that total, $6.5 billion corresponds to prepaid medicines, another $3.91 billion to health insurance and nearly $1.52 billion to complementary plans.
(Read more: EPS Famisanar announces action plan after extension of administrative intervention)
Even in the breakdown of the information it is possible to analyze that Health insurance has increased its market by 79% in the four years, followed by complementary plans that have grown by 75% in that period and prepaid plans by at least 51%.
Now, remembering that the pandemic was one of the drivers of health spending, since people with purchasing power made use of these plans to integrate them into their system, the truth is that today The uncertainty surrounding the future of health is one of the reasons why the sustained increase in sales of this type of voluntary plans has been consolidated.
(See: They warn of the risk of collapse in the recognition of resources for high-cost diseases)
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Even during 2021, the year of the pandemic, the greatest growth compared to 2020 was for purchases of prepaid medicines, which increased 24% from one year to the next and also the complementary plans that increased by 18%.
(See more: ‘Large investments deserve a pause due to uncertainty’: Marly Clinic)
In the case of 2022, the situation changed as complementary plans gained ground, increasing by 21%, compared to 2021, and the health insurance market rose by 16%. In fact, it is possible to mention that insurance has had a sustained participation behavior, Well, in 2023 they grew by 18% and in this year’s estimates they are already close to 19%.
It is worth highlighting that the market share last year alone corresponded to 52% of prepaid medicines, followed by insurance, which accounted for 31.4% of the pie, complementary plans 12.2% and ambulances 4.4%.
For Ana María Vesga, president of Acemi, a union that brings together the EPS of the contributory regime, the deterioration that the health system is experiencing, especially due to the intervention of the EPS, It is reflected in the fact that Colombians are having greater difficulty accessing appointments and in the same way the medicines are delivered. Factor that predominates within the greatest expense.
(Read also: Health reform: they urge not to throw away the public-private experience)
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For this reason, within the arguments for this expense, the board reiterated that the largest purchase of voluntary health plans “It is a product of the fact that people who have a little more purchasing power decide to buy a policy or go for a prepaid one to insure themselves.”.
(See more: What are the EPSs that are in the process of withdrawing from the health system?)
Another point to highlight is that from 2010 to 2024 the variation in the composition of the market shows that in that period the prepaid medicine have lost 14% participation. Added to the casualties are ambulances, which are decreasing by 0.9%.
Meanwhile, supplemental plans have been gaining ground with an increase of 10.7% between 2010 and 2024, as have policies growing at a rate of 4.7%. Since 2021, this type of insurance has gained 5% participation.
(Read: Health financial crisis threatens to worsen drug delivery problems)
Additionally, during the last decade an average of 3.8 million people have reported having a PVS. In 2023 alone, some 161,083 Colombians indicated they had a surgery hospitalization policy, 1.33 million had contracts with prepaid medicines and 724,693 had a complementary plan with an EPS. It is also added that 464,196 citizens had student health insurance and in addition 309,330 people accepted ambulance service, home medical assistance, etc.
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Sales participation
Although the increase in these plans is marked within the health system, it is estimated that during 2023 only in prepaid medicine, 45% of sales were concentrated in Colsanitasfollowed by 21% in Colmédica and 17% in Coomeva. In a smaller proportion there are Medplus (6%), Colpatria (6%) and Colsanitas (5%).
(Read: The New EPS suspended payments to 144 IPS due to inconsistencies in invoices)
Analyzing the complementary plans, 40% of the participation is Compensar, followed by Sura with 30%, Sanitas with 12%, Famisanar with 8% and SOS with 5%. In the case of health policies, Suramericana Vida occupies 70% of the participation, continued Allianz with 16% and Bolívar with 10%.
Finally, in the ambulance and home medicine plans, contributions from EMI represent 67%, In addition, 26% corresponds to Emermédica and 5% to Medical Assistance.
