The discussion on health reform increases the pulse, after the extraordinary sessions were approved so that in the plenary session of the House of Representatives The articles that seek to modify the Colombian health system are debated and approved or not.
(Read: ‘Health at stake’: concerns about possible approval of the reform)
However, while it is being discussed in the Congress of the Republic, actors in the sector have expressed their concern about the impact that approval of said bill could have. Taking into account that, from now on, the effects of the structural crisis of the system are noticeable, not only due to definancing, but also due to the pause and closure of health services.
According to a letter sent by former ministers and former vice ministers of health, to the current portfolio, the year 2024 closes with an unprecedented crisis for the health system in Colombia. Thousands of patients, mostly with chronic or orphan diseases, They have lost the treatments they received periodically and in a timely manner.
(See more: Health collapse: former ministers and former vice ministers say that in 2025 it could be worse)
For example, complaints, petitions and protection resources have grown alarmingly, with increases of more than 30% and 40% compared to 2023, while opportunity in access to health services continues to deteriorate further.
The financial outlook is also bleak. In 2024, more than 1,200 IPS closed their doors due to insufficient resources, leaving more than 3,000 medical services permanently closed and another 8,000 temporarily suspended.
(Read also: Patients and health workers call for a sit-in due to crisis in the system)
An example of this is the situation they are experiencing 37 public hospitals in Antioquia that will stop offering non-urgent care to users of the New EPSjustifying that this is due to the entity’s lack of payment.
Plenary of the House of Representatives on health reform
Cesar Melgarejo – Portfolio
Faced with this, the Association of Public Hospitals of Antioquia emphasized that The debt amounts to $170,000 million, which is generating a crisis in hospitals that depend on these resources to cover salaries.
(Read: Government would face operational challenges to assume EPS Sura users)
Added to this is the intervention of eight EPS by the National Health Superintendency and the placing of one more under special surveillance, evidencing a systemic financial problem with equity losses that exceed $7.5 billion, not including the balances of the New EPS.
For this reason, the former officials mentioned the definancing of the Capitation Payment Unit (UPC) and the maximum budget, which are aggravating the situation. Even, A deficit of more than $5.5 trillion is projected by the end of the year.
(See more: EPS Sura assures that the difficulties of the health system have not yet been resolved)
In fact, Bruce Mac Master, president of Andi, highlighted that they do not agree with the statements of the Minister of Health, Guillermo Jaramillo, who in an interview given to EL TIEMPO, assures that The UPC has increased to levels that today would allow the health sector to serve Colombians.
Plenary of the House of Representatives on health reform
Cesar Melgarejo – Portfolio
He details that some studies that have been done, not only of Andi, They record that this increase should be at levels between 15% or 25%. Therefore, if the UPC is not increased by these values by 2025, it will not be possible to pay and cover the needs of the system.
(See more: Sura EPS responds to the Supersalud decision on its progressive dismantling)
“In the system, more than 50% is being operated today by EPS that are either owned or operated by the Government. That is, the major operator of the health system today is the State. The Minister also says that through the intervened entities the system has improved, but that is not what the patients think, nor what the surveys say.”, he states.
Furthermore, the former officials indicate that the National Government, “headed by the Minister of Health, (who seems to be in transit to electoral politics) uses the threat; denies and distorts reality; and evades the responsibility it has in the face of this crisis that foresees the collapse of the health sector“, they say.
(Read: Audifarma requests a business reorganization process before the Supersociedades)
This behavior would not only be minimizing the achievements of the last 30 years, but would also ignore citizen support for the system, which according to a survey carried out by the Ministry of Health itself in 2022, Only 8% of the population rated the system as bad or very bad.
The Minister of the Interior, Juan Fernando Cristo Bustos.
Cesar Melgarejo – Portfolio
Reform under pressure
Regarding the reform, they highlight that the Government has promoted a reform project in Congress that does not solve structural problems and that the lack of technical focus, which has led to a worsening of access indicators and a general deterioration of the system.
(See more: Financial risk of public IPS: more than $12.4 billion in portfolio and growing deficit)
“If we continue along this route, the deterioration of the health system will deepen in the year 2025. As we have already mentioned in other communications, the reform project filed in the Congress of the Republic does not solve the structural problems of the system. We insist on frank, direct and evidence-based dialogue as the truly democratic path to establishing changes and adjustments that resolve these structural challenges.“, they emphasize.
In turn, the Colombian Association of Scientific Societies (ACSC) and other unions in the sector called on the representatives of the Chamber to measure and foresee the consequences and impacts that it could have. the current reform that is being discussed if it is approved.
(Read: Crisis of the health system: the dangers of defunding and deterioration in care)
In detail, they highlight that health is a fundamental right whose guarantee must be the result of a broad, serious and transparent debate.so the complexity of the reform requires analysis of the financial, operational and social implications.
“The reform as it is proposed does not solve the problems of financing the system, operational and health insurance and can also become an instrument of regional manipulation and misappropriation of resources.“, they denounced.
The Minister of Health, Guillermo Jaramillo and the Minister of Transportation, María Constanza García, in the plenary session of the House of Representatives on the health reform.
Cesar Melgarejo – Portfolio
Concern increases
Although health is one of the areas that involves all Colombian citizens, other economic sectors and actors in the system have expressed their concern about the fact that they are “rushing to approve a reform.”
In that sense, María Claudia Lacouture, president of AmCham Colombia, warned about the risks that exist in the health system in Colombia in relation to the definition of the UPC for 2025 and the process of health reform.
(See also: EPS Sanitas begins third phase of change of pharmaceutical suppliers)
“Health reform must be discussed responsibly by the Government and Congress, guaranteeing broad consultation. Running to get the vote goes against building the best system for Colombians, since there are still relevant issues that do not solve the underlying problem”Lacouture noted.
He added that the definition of the UPC for 2025 must close the resource gap that overwhelms the system due to insufficient budgets, avoiding major impacts on the service and supply of medicines.
(Read: They warn that EPS financial statements continue to worsen)
Although the extras are being carried out at this time, the representative for the Democratic Center, Andres Forero, warned that during the plenary vote, the Minister of Transportation, María Constanza García, was inside the premises and assured that she was there “to guarantee quorum in the reform”. Also, they were the Minister of Mines, Andrés Camacho and the director of Colpensiones.
The presence of the officials generated discontent, therefore, Health is not a transversal issue across their portfolios and entities.
