Last Friday, at the end of the afternoon and when there were very few people in the Camera of Representativeyesthe presentation for the first debate of the health reform, one of the most criticized. But, What is new about the 527-page document that was left with the signature of the conservatives and ‘La U’, although without the consent of Dilian Francisca Toro, director of ‘La U’, and, as was known, without the endorsement of the liberals ?
The EPS continue as in the initiative proposed by Carolina Corcho, Minister of Healthonly that they do accept the name of Health and Life Management Entities. The regional funds that the parties criticized are maintained and it does contemplate the direct transfer of resources, as well as the prohibition of vertical integration.
(‘Health reform project includes ideas from parties and society’).
The presentation groups common elements among the accumulated projects, such as: “the need to strengthen Primary Health Care, public hospitals, the dignity of workers in the health sector and the improvement of the flow of resources through the use of the direct transfer mechanism from the Addresses”.
So, “The focus of social health insurance is maintained as a guarantee of comprehensive universal health care.” In addition, it is maintained that the State will affect the Determinants of Health, “in order to improve the general and individual living conditions of the inhabitants of the national territory”.
As for the EPS, which are the cornerstone, it must be said that they have been performing functions such as ensuring, which according to Fedesarrollo is what has allowed today to have 93% coverage; mediate state resources, manage health riskamong other.
(The keys to the health reform paper that was filed).
In the project, many of these functions are removed from them, leaving only audits, management of primary care centers and a few others. It takes away from them the role of insurers and health risk managers. In the document of the presentation it is read that the EPS that “comply with the qualification and permanence standards in force in the regulations, and who wish to continue participating within the Social Health Insurance System, will become Health and Life Management Entities in the next two years. To do this, they must present a debt and payment acknowledgment plan with respect to health service provider entities.”.
After two years, the EPS, which would be called Managing Entities“may be of a private or mixed nature”and they will have to fulfill certain functions that are distant from those they exercise now. It is detailed that in this transition process, “they will receive the annual per capita value without funds situation, for medium and high complexity services, which will be recognized monthly according to the definitions of the Ministry of Health”.
(If health reform falls, there would be a positive economic impact).
It reads that “The National Health Superintendency will authorize, through an administrative act, the operation of the Health Promoting Entities that, through their transformation into Health and Life Managers, are interested in managing medium and high complexity services for the population that is authorize and hire them and the fulfillment of the other functions that correspond to them”.
That is to say, the role of insurers requested by the parties is removed, and it passes to the Adres. According to Dane Quality of Life Surveythat role has allowed the Health insurance is at 93% by 2021 and the Ministry of Health reviews it at 99% in 2021.
(Former Minister Ruiz highlights the learning curve of the health system).
According to him former health minister, Fernando Ruiz“in practice individual insurance disappears. The address only has functions on resources. The individual health risk ends up being assumed by the person himself as well as the associated financial risk”.
In the presentation the direct turn of the addressvertical integration is not allowed and what is proposed by the parties in which the now Managers “they will only receive up to 5% of UPC resources for administration expenses (a value that will be estimated in the regulations). They will not receive the UPC resource for health or payment of financial benefits. These resources will be centralized in the Adres and will be sent directly to health service providers and health technology providers.”.
(‘A new health reform project was not needed’).
A point that was taken up from the articles of the parties is “the debts that the liquidated EPS have left in the public hospitals will be paid gradually, with future terms agreed with the Ministry of Finance”.
In the presentation, regional funds would be created, but as part of the Single Public Health Fund and it is added that “there will be a manager of the Adres who will order the expenses against the resources of that regional fund. Likewise, it is made clear that it is an Account Fund. In this way, the observations of the liberal party, the U and the Conservative party are collected, specifying that such funds are not entities, but only an account”.
The debate awaits the articles in the Seventh Commission and plenary sessions, where there will be changes.
CLAUDIA M. QUINTERO RUEDA
Journalist Portfolio
