The Petro government’s health reform began its debate again in the Seventh Commission of the House of Representatives with a presentation that has generated a series of criticisms, especially, by the opposition.
(See: Key week in Congress for two of the seven Government reforms)
The representative of the Democratic Center, Andrés Forero, maintained that the articles that are being discussed are very similar to the one sunk in the Senate in the last legislature, which is why they tried to vote a negative report and even a postponement proposal, that were not granted by vote of the congressmen.
Now, during the discussion, the speakers of the reform and specifically the representative Andrés Mondragón assured that what is intended with this new article is to solve the problem of inefficiency and possible cases of corruption within the Colombian health system.
(Read more: The changes brought by the presentation of health reform 2.0 filed in Congress)
In that sense, the congressman stated that according to a report from the Inter-American Development Bank (IDB), At least 20% of health spending in Colombia does not contribute to improving the indicators of the Colombian population. For this reason, he insisted that the purpose of this debate is clearly inclined to strengthen Primary Health Care.
He added that according to the Bank’s report, In the country, 17% of spending on hospitalizations was for reasons and situations that could be preventable with primary carea situation that would be costing the system at least $1.7 billion.
(See: Technical tables on health reform end: conclusions from the actors in the sector)
In addition, he mentioned that public spending on health is between 4 to 7 pp higher than the OECD average, which is estimated between 12% and 15%, and only on medicines. The health system pays 20% more than the laboratories charge.
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“In Colombia, pseudo insurance companies, which are EPSs, have proliferated. They continue to have negative assets that do not allow them to demonstrate that they are supposedly insurance companies. The flexibilities that previous governments have given did not allow them to guarantee health in this model. They do not capitalize, they do not insure and they do not attend. They have enjoyed the business”, said Mondragón.
(Read also: After technical table, health sector actors call for consensus on the reform)
For this reason, the representative expressed that the current system suggests that the insurance model facilitates the network of resources, which leads to acts of corruption. “There are luxury and operating expenses such as health costs, there are agreements that restrict competition to cause extra costs in medicines.“, said.
From the financial side, the speakers of the articles assured that it was agreed that the financial risk will be in charge of the Adres and that it will be done through an integrated network of private, public and mixed actors.
(See: Patients file protection for alleged exclusion from the health reform table)
“There are cost overruns and arrangements with drug providers and payment of services for deceased and unaffiliated users. According to the Attorney General’s Office, there are 29 EPS with the same modus operandi or improper practices. They get together so they can steal. We are generating death by maintaining this system. 90% of deaths in pregnant women are preventable. In addition, 6,689 children died before their first birthday. These results are elements that we want to solve”said Mondragón.
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Likewise, representative María Eugenia Lopera, indicated that in the midst of this reform, Adres will have to guarantee the adequate collection, administration, flow and control of public resources of the health system. Likewise, the UPC will be set by the Ministry, taking into account the advisors.
(See more: They request that health reform be processed as a statutory bill)
On the other hand, the rapporteur congressman, Alexander Quevedo, stated that this is a bill that went from a little more than 150 articles to about 58 with proposals that have been made along the way. That’s why, The focus is to propose the universality of the right to health, which is guaranteeing, efficient and supportive, which privileges life.
“Today, as it is, the system is managed by the EPS and they are empowered by the provision of the service and everything that has to do with the law. Something that should be at the head of the State. There was talk that this system wanted to nationalize health. All insurance management is public, private and mixed, which includes health and life managers“, indicated Quevedo.
(Read: What does it mean that the health reform is going to be processed as an ordinary law?)
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Opposition approaches
Although this has been one of the most debated reforms during the Petro administration, since it aims to completely reform the health sector. Representative Andrés Forero indicated that the reasons why The postponement of the discussion was proposed based on the fact that until now, the Government has not taken responsibility for some of the financial problems of the system.
(Read: Health reform: the key points of the new project filed in Congress)
In this way, he indicated that the maximum budgets for September, October, November have not been paid and it is not certain that those for December will be paid. In the words of the congressman, This aggravates the situation of patients with orphan diseases, who have reported several deaths due to lack of medications that are covered with these resources.
“It makes no sense that they are saying here that they are supposedly going to solve health problems in the future, when at the same time high-cost patients are being neglected. The Minister acknowledged that he has used resources, which theoretically should have been allocated to insurance, to build hospitals that were not finally built and extramural equipment.”, he denounced.
(See more: National Government resubmits the health reform project)
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What were they left with?
During the debate this Tuesday, November 12 in the House of Representatives, The congressmen approved a total of 21 articles, after five hours of debate.
In detail, some of them have to do with complementary health services, such as point 21 of the text, which are transportation, lodging, care or personal assistant services at home, according to those considered by the Ministry of Health. and Social Protection.
(Read: Coosalud responds to accusations of corruption and denies diversion of public funds)
Additionallythe green light was given to article 37, which refers to the reference and counter-reference system, which is the set of processes, procedures and technical and administrative activities that will allow people’s health services to be adequately provided, “guaranteeing the continuity and comprehensiveness of services in the Integrated and Comprehensive Territorial Health Networks (RIITS) that operate in the functional subregions for health management“.
Another notable aspect is article 40, which is the preparation and approval of the budget of the State Health Institutions (ISE)At this point, it is said that these entities will be governed by budgets, according to the standards defined by the Ministry of Health and Social Protection.
“Such budgets will obey the standardization of the services offered according to the typologies of the functional subregions for health management defined by the Ministry of Health and Social Protection.”says the article.
(See more: Nationalization of health: what is the impact of this process)
In total, the approved articles were the 37, 38, 39, 40, 42, 45, 51, 52, 53, 54, 55, 56, 21,23,24,26,27,46,47,49 and 50.
With the 21 articles approved so far of the 58 it has, the Chamber has already discussed 36% of the articles.
