Hopeless. These are the health actors, who will start in 2025 due to the “bad decision” made by the Government of Gustavo Petro regarding the calculation of the Capitation Payment Unit (UPC). According to the portfolio of this line, The premium indicator that insures all Colombians will only increase by 5.36%, a figure that officials suggest is sufficient.
(See: Afidro warns that the UPC should have increased to 16.4%)
However, experts have highlighted that not only is the increase insufficient, but it will also entail a series of serious consequences, such as the non-provision of services for patients, as well as a deepening of the medicine shortage crisisdue to lack of resources.
Different economic study centers, unions and actors have given estimates of the deficit with which health would begin this year, due to the poorly calculated UPC and the other financial problems that the system has. Of the three projections addressed by the entities, the average It is at least 12.9 billion financial gap for the sector.
(Read more: Criticism grows against the increase in the UPC for 2025)
According to estimates by the Anif Center for Economic Studies and the Association of Pharmaceutical Research Laboratories (Afidro), the UPC for this year should have increased by 16.4%, taking into account that These monies are intended to cover the services and medications included within the Health Benefits Plan (PBS).
Although within its projections it was estimated that only in maximum budgets there was already a deficit of $4.6 trillion between 2022 and 2024, Therefore, it was projected that if a bad calculation was made in 2025, the country would start with a debt of $19.7 billion.an amount that is equivalent to what is necessary to cover the UPC of 15.7 million people who during 2023 were in a situation of monetary poverty.
(See also: 5.36% increase in UPC deepens health crisis and aggravates impacts on patients)
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According to what they explain, the estimates suggest that since 2021 the UPC calculation is underestimated, on average, by about 2.8 percentage points (pp). For example, when observing the gap in 2022, it is estimated that it was 2.4 percentage points, while for 2023 it was 2.6 percentage points.
(Read more: Uncertainty in the health system by UPC calculation)
But if you look at the case of 2024, It was established that the system needed a 15.6% increase in the value of the UPC, but the decreed was 12%, which caused the widest gap in recent years with 3.6 percentage points. And when looking at the data for 2025, the gap increased by 11.04 percentage points, when the suggested UPC was 16.4% and was decreed at 5.36%.
“This value is essential to cover next year’s health care delivery needs and does not address the accumulated deficit from previous years. Therefore, it is essential to continue discussing mechanisms within the budget to meet the needs of the system and ensure timely payment of previous debts.”says the study of both entities.
(See: Adres is preparing measures to regulate accident claims without Soat)
Now, not only Anif and Afidro warned of the deficit in the system this year. In the case of the National Association of Businessmen of Colombia (Andi), This fiscal gap would be at least $10.9 billion, taking into account the Capitation Payment Unit (UPC) and the estimated deficit in insurance.
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“If this level of accidents is maintained and following the best projection of income and expenses for the system, a minimum increase in the UPC of 16.9% would be required for the year 2025. This increase would not cover the definancing of previous periods due to insufficient the UPC”says Andi.
As in the previous case, taking into account the increase decided by the Government, with respect to the Andi estimate, andThe definancing of the UPC would have a gap of at least 11.54 percentage points.
(See more: In November, Adres transferred $6.88 billion to the health system: this is how the accounts go)
According to what the union said, the problems in the health system do not come from recent times, but from previous years, where the financial deficit has its origin in the insufficiency of the UPC. For this, They insist that this calculation must be correctly carried out and have sufficient resources to provide the health care that the Colombian population requires.
The increase in concern also increases because according to Ana María Vesga, president of the Colombian Association of Comprehensive Medicine Companies (Acemi), a union that brings together the EPS of the contributory regime, This year’s deficit would be about $9 billion, according to the entity’s calculations.
(Read also: Acemi says that the quality of health services requires a well-adjusted UPC)
“The decision to increase UPC by 2025 puts the health and lives of patients at risk. It lacks a technical reason, is inconsistent with the increase in the minimum wage and is contradictory in that more than half of the information required for its calculation had to be provided by EPS, under state intervention. There simply will not be enough money to cover the care of Colombians. It is essential to review your calculation, reproduce and make the exercise public and proceed with the readjustment”Vesga noted.
Health System – How to get information about your health coverage.
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Relationship with inflation
One of the factors to increase the value of the UPC in Colombia is based on the behavior of inflation. The Government, led by President Petro, talks about a real increase in the UPC, arguing that the expected inflation this year will be lower than the nominal 5.36% increase decreed, a argument that contrasts with the criterion for increasing the minimum wagewhich was taken with the inflation caused in November and not with that expected for 2025.
(See: Health reform: implications of considering it a statutory law)
However, health experts assured that the calculation is contradictory. Andrés Vecino, associate professor at Johns Hopkins University, indicated through his social networks that the health component was one of those that grew the most in the November variation.
In fact, reviewing the Dane figures, This division alone increased 5.63% in the eleventh month of 2024, which is even greater than the same increase in the UPC decreed by the Government, which was 5.36%.
Also, another aspect to consider is the increase in the minimum wage that the Government set at 9.5% for this year. Therefore, according to the expert, This indicator is just one of the spending pressures to which the health system is subjected.
(Read: ‘We need spaces where health system actors have a voice’: Abbvie)
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This, taking into account that health is a labor-intensive “industry”, the salaries of human talent represent at least two-thirds of the expenditure of resources. In addition, referred to others such as the increase in frequencies, the increase in health prices, the price of the dollar and the inclusions.
(See more: Andi estimates that the UPC should grow 16.9% by 2025, thus stabilizing the operation)
From another point of view, Camilo Herrera, co-founder of Raddar, highlighted that by taking into account the dynamics of health it is possible that these will translate into greater demand, so some of the costs such as those of health insurance possibly are going to increase and especially those that are linked to the workforce, that precisely because of the increase in the minimum wage they are going to be pressured.
“Health may have relatively high inflation this year, we would have to look at how much was actually left last year and under that logic, this increase in inflation would be due to higher costs in the production of health goods and services and due to shortages in the market for many goods, which are theoretically free, such as OTC medications and insurance policies, which in the face of higher demand will inevitably come under pressure and prices will rise”, he concluded.
(Read: ‘Health at stake’: concerns about possible approval of the reform)
