The National Government, through the Ministry of Health, issued Decree 858 of July 30, 2025with which it regulates some key points contained in the health reform project, which is still going on the first debate in the Senate and that until today has not been informed when it will be discussed.
(Read: They warn risks in care of patients with new health implementation)
The regulations have the objective of “reconfiguring immediately” the model of health services in the country towards a preventive, predictive and resolutive. In that sense, lExperts say that patients are those at risk because the decree limits them the freedom to choose their care centers.
Additionally, they argue that The Government lost the claim that had to keep the presidency of the seventh commission of the Senateso they do not see a positive future to the discussion of the reform in that instance, a fact that would motivate the articulated via decree.
This was confirmed by Jesús Albrey González, president of the Bar Association in Medical Law, who also added that it is already glimpsed that it would not succeed in the discussion of the Congress. “That is why we believe that the Government will not continue to insist with the reform and will initiate its implementation by way of decree”He said.
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Experts say that the Government will choose to impose reform by way of decree in the face of failure in Congress.
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On the other hand, the director of Thus is in health and former minister of the portfolio, Augusto Galán, said that the government is exceeding its powers to regulate and somehow “transgress” standards such as the Law 100, 1122, 1438 and the same statutory lawin relation to the health assurance and health care model.
With the above on the table, The manager said that one of the points that has generated more concern is the future of patient care.
“The most shocking thing is that the transition is abrupt and that will harm users and patients in the midst of this complex regulations that try to impose. They will be dedicated to greater access barriers and more difficulties in receiving health services”Galán argued.
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They warn that the decree transgresses norms such as Law 100 and the Statutory Law by modifying the assurance and care model.
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He also added that the greatest impact will be for patients and users, taking into account that the transition limits freedom of choice, because all citizens are obliged to be attached in primary health care centers (CAPS) defined by the State.
“With so much abrupt and sudden modification in administrative processes, in the procedures and the confusion that this can generate in their implementation process, patients and users will be dedicated to greater difficulties in accessing the provision of services and the use and access to medicines”He said.
It is worth noting that as mentioned in the standard, this will have application for all health actors, including health or territorial promoters whether departmental, district and municipal; the Superintendence of Health; the EPS; IPS; Adres and social communities, as well as the other institutions that intervene directly or indirectly, in the guarantee of the right to health.
(Read: Health actors ask urgent technical and financial adjustments for UPC)
The abrupt transition to Primary Health Care Centers (CAPS) would limit free choice and increase access barriers.
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And the responsibility?
Another of the analysis points is concentrated in the “blurring” that some essential roles would have in the health system.
Faced with this, the president of ACEMI, Ana María Vesga, said in Caracol Radio that the regulations have no clarity in the functions and fragmentation at the levels of attentionwhich could impact not only financing, but also on users.
“The EPS fulfill a role of agent in the system that has functions from end to end and you can be responsible for those functions and your patients to the extent that you have tools to do so. But, the criticism and what the EPS are not willing, is to continue having the responsibility without the instruments to comply with it”He said.
(Also read: ‘We have made advances in terms of financial sustainability’: capital health)
EPS maintain responsibilities without clear instruments of execution, which puts attention at risk.
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Vesga also emphasized that the underlying problem is the lack of protection that system users would face, as they would be “sailing” among several health agents that will be part of the system, such as primary health care centers, territorial entities, etc.
From another point of view Galán assured that EPS are reduced to marginal functions of “collaboration”, a fact that generates many difficulties.
“Who is responsible for being complex to understand, implement and above all that users and patients really benefit from these modifications and changes. That, in this way as you are trying to impose, is too complex and harmful to users”, He questioned.
(See: The money that Colombia could save itself if it improves literacy in health)
They question the constitutionality of the decree and criticizes the lack of clarity about the financing of the new system.
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Similarly, the president of the Andi, Bruce Mac Master, emphasized that the regulations do not consider patients who today do not know what the care route is or those who have to interrupt their current route. “The president decided that this was one of his flags, and never understood what the risks were, to which the patients are subjecting”He added.
For Jesús Albrey Gonzales, there is an important point to see and that is that the decree issued by the Government gives the National Superintendence of Health, The order to update the administrative acts of qualification of the EPS. “That does it by establishing conditions to verify the fulfillment of the health model, adopted in the decree,” he concluded.
(See more: Fomag clarifies accounts with Santa Fe Foundation and Active New Health Network for Teachers)
The Constitutional Court ordered to review the methodology with which the UPC is calculated in the health system.
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Why the reform?
As said by Augusto Galán to this medium, it is not yet understood what is the purpose of health reform, if it is being imposed by decree. “The problem is that this reform, by way of decree, exceeds the powers that the National Government has to reform without law, the current norms“, said.
From another front, the president of the National Association of Entrepreneurs of Colombia (ANDI), Bruce Mac Master, referred to the decree stating that “the Government decided to impose its idea of health system, most likely illegally and unconstitutional.” He stressed that this does not provide clarity to how the financing of the system and the services that will be incorporated will be.
(See: Gustavo Petro’s economic discourse, either do health figures either)
Diana K. Rodríguez T.
Portfolio journalist
