On December 30, the Colombian Government set the value of the Capitation Payment Unit (UPC) for the year 2025, establishing the amount that will be paid annually to insure a citizen within the health system.
(See: National Medical Board demands urgent reform of the country’s health system: what it proposes)
For the contributory regime, the increase was 5.36%, placing the annual value at $1,521,489. For its part, the subsidized regime was established in $1,323,403. However, the question arises: Is this increase enough to sustain the Colombian health system?
According to a study carried out by the National Association of Financial Institutions (ANIF) in collaboration with Afidro, The increase necessary to cover the costs of the health system should have been 16.4% in the contributory regimewhich would have placed the UPC at $1,680,916 COP.
(See more: Colombian Patients demand urgent responses from the Government regarding the health crisis)
This calculation considered variables such as the increase in the use of health services after the covid pandemic, population aging, technological advances and the increase in the prevalence of chronic diseases.
Additionally, costs of medical supplies and medications have experienced significant inflationary pressure. According to figures from the National Administrative Department of Statistics (Dane), Costs associated with the health sector increased by 9.2% in 2024, well above the increase decreed for the UPC.
(Read also: Financial crisis and access to health, a worrying panorama for the sector)
This gap of 11.04 percentage points between the technical estimate and the decreed adjustment increases financial pressures on the system. “This insufficient adjustment compromises the system’s ability to ensure the delivery of health services in a timely and efficient manner in 2025.“warned an ANIF spokesperson.
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For its part, the Colombian Association of Hospitals and Clinics (ACHC) also expressed its concern about the impact of this adjustment on the financial sustainability of health centers.
(See more: Minsalud details the inconsistencies of the EPS for the calculation of the UPC)
The difference between the necessary increase and the decreed one generates direct consequences for users. Lack of resources could fragment service delivery, translating into longer waiting times for medical appointments, delays in access to specialists and delays in surgeries and treatments. This situation could become especially acute in remote regions, where hospital infrastructure is already limited.
In addition, drug shortages could worsen. According to the latest report from the National Institute for Food and Drug Surveillance (Invima), at the end of 2024, Of 195 medications under monitoring, four are at risk of shortages and seven are already out of stock.
(Read: Rasa Foundation, on the situation of the health system: ‘the Government does not listen to us’)
Among these is insulin, essential for the treatment of more than 1.8 million patients with diabetes. The lack of this medication could interrupt treatments and deteriorate the health of those affected.
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Another foreseeable consequence is the increase in users’ out-of-pocket expenses, that is, direct payments for medical services not covered by the system. Although Colombia has stood out in the OECD for having one of the lowest out-of-pocket expenses, The deterioration in the availability of services could lead more citizens to resort to private services.
(See: Patients Colombia requests the Attorney General’s Office to protect the fundamental right of health)
“Users could be forced to pay for private consultations and exams due to the delay in the public system,” said a health analyst.
This phenomenon is already evident in the growth of premiums issued by private health insurance. Between 2022 and 2023, these increased by 16.8%, and between 2023 and 2024, The growth was 23.3%, reflecting greater household spending to access private health services. Added to this is the increase in the contracting of complementary plans and prepaid medicine, which shows a growing distrust in the public system.
(Read: Government warns that fiscal reality limits a further increase in the UPC)
