The Colombian health system is going through one of its worst crises, marked by uncertainty, defunding and deterioration in the quality of care to patients and users.
(Read: EPS Sanitas begins third phase of change of pharmaceutical suppliers)
In this context, the recent reform project approved in the first debate by Commission VII of the Chamber has raised concerns, by retaining the same conceptual errors of previous initiatives and lacking solid technical and fiscal support.
Despite the expectations of technical dialogue in the Technical Table, The debate on the reform did not comply with a calm and evidence-based analysis. The hasty approval of the bill in Commission VII, according to experts, reduces confidence in the process and hinders the possibility of building a reform that resolves the structural problems of the General Social Security Health System (SGSSS).
(Read more: They warn that EPS financial statements continue to worsen)
According to a letter sent by former ministers and former vice ministers of health, The project does not have an explicit fiscal guarantee from the Ministry of Finance and is not properly funded either.raising concerns about its viability. In addition, it retains a structure similar to the one that was archived in April because it was classified as inconvenient and insufficient.
While the debate on reform progresses, users of the system face a growing deterioration in service delivery. In the last two years, Chronic non-communicable diseases such as high blood pressure, diabetes mellitus and chronic kidney disease have shown an increase of more than 30% annually..
(See also: Financial crisis in Colombian health: EPS debt reaches $18.9 billion)
Health
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Invasive cancer cases could increase further in 2024, while the incidence of HIV-AIDS went from 25 to 28 per 100,000 inhabitants in the last 48 months. Low vaccination coverage is another worrying sign. Currently, it only reaches 84%, far from the ideal of 95%, which puts children and adolescents at risk and exposes the country to public health emergencies.
(Read: Appointment assignment, main barrier for patients to access health services)
User dissatisfaction is evident, they highlight, because between the first and second quarters of 2024, Requests, Complaints, Claims and Suggestions (PQRS) increased by 22%going from 117,241 to 143,292 per month.
Besides, Until August of this year, more than 175,000 guardianships related to the health system were filed, an increase of 43.5% compared to the same period in 2023. Of these, 30% corresponds to the lack of delivery of medicines, a problem aggravated by the shortage and the slowness of Invima procedures.
(See also: Supersalud intervenes EPS Coosalud due to administrative and healthcare deficiencies)
Health
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Defunding and operational collapse
The deficit of the health system is another critical axis that the actors highlight. Accumulated debts, including unpaid maximum budgets from previous years, They could exceed five trillion pesos by the end of 2024 if the necessary transfers are not made. This defunding affects the entire sector chain, including EPS, public and private hospitals, pharmaceutical companies and logistics operators.
(Read more: In October, Adres allocated $7.13 billion for health insurance)
The Health Promotion Entities (EPS) intervened by the Health Superintendency show a greater financial deterioration than they had before the interventions, the case of the New EPS being a notable example. For its part, State Social Enterprises (ESE) face increasingly precarious conditions to meet the financial indicators necessary to operate.
Health reform
Ministry of Health and Social Protection
For the first time, The general budget of the Nation will be issued by decree, and it is unknown how much will be allocated to the health sector in 2025. The lack of a technical and actuarial analysis to determine the Capitation Payment Unit (UPC) poses additional risks to the stability of the system, which could further aggravate financial precariousness.
(See also: Lawsuit against the Minsalud and Invima for shortages of medicines)
Although the National Government insists that the situation reflects better management of the system, the coverage, quality and results indicators contradict this statement. “Resolving the current chaos does not exclude the need for an in-depth debate on the evolution of the health system, but requires immediate actions to guarantee operational and financial stability.“, they indicated.
