The discussions around the path that will be taken on the future of the health system do not advance, not only because the debates and the papers on the reform are stuck in the Congress of the Republic, but also because while the dialogue is expected, the crisis is exacerbated by costing the lives of thousands of Colombian patients.
Although these proposals for reform, the government, the alternative and the archive, none of them are having a procedure in the YD Legislative are filed today in the countryE according to experts, the articulated one based by the Government does not solve the problems, nor the structural crisis to which the health system has been conducted.
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Now, while continuing in the pause of debates, Patients are still denounced the lack of treatments, medicines and the brake of services. However, experts agree that this situation is being experienced by the definance of the system, as well as the “intransigence of the government.”
Even Diego Gil, director of the Colombian Federation of Rare Diseases (FECOER) denounced that so far this 2025, At least 1,500 patients with these conditions have diedand not for “unavoidable” reasons, as the Ministry of Health said, but for the lack of access to timely treatment about their diseases.
According to the figures expressed by the Federation, of the endemic channel between 2018 and 2024, the average deaths of people with rare diseases arrived at its maximum data at about 160 deaths, figure that was reached in the month of June, because in the other months it remained below that number.
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The Congress maintains the process of the three proposals for health reform.
Courtesy Senate
However, the situation is exacerbated during this year because the deaths of people with rare diseases are not only above the average of the previous seven years, It has also established itself as the highest data of the last 10 years.
Specifically Fecoer reported that in January there were about 140 deaths, in order to be a little above that number. Thus, in March the first peak is presented with more than 205 deaths, but in April it descends to about 200. In May they rise again to a little less than 220 and by June and July the data is reduced to approximately 170 deaths.
But, Just analyzing the month of August of this year, the number of deaths shoots and reaches 240 deaths. Thus, during that 2025 the 1,500 people who lost their lives are already passed in these conditions. “In this year, more patients of rare diseases die every month than in the last seven years,” Gil said.
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In August 2025, the highest peak was recorded with 240 deaths in a single month.
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A FUTURE REFORM
Returning to discussions on health reform, both Diego Gil and other experts, agree that the reform does not solve the problems of the system, because the insufficiency of the Capitation Payment Unit (UPC) and the challenges of Colombian health is still ignored.
“We have warned in multiple opportunities that the reform made by the National Government does not resolve the complexities and problems of the population with rare diseases. From different points of view, it is already demonstrated with the failed model of the teachers that does not work. How many people do we need to die to be able to realize that urgent and immediate measures must be taken to resolve the crisis?”Said the director of Fecoer.
Along the same lines, Andrés Forero, representative to the Chamber by the Democratic Center, assured Portafolio that the resistance of the seventh commission of the Senate to approve this bill, lor that evidence is the intransigence that the government has had, which built this initiative on their backs to doctors, academics and, mainly, of patients.
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The historical average of deaths from rare diseases between 2018 and 2024 was 160 cases per month.
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“It must also be remembered that there are two experiences that show what can happen if this reform is approved. The first is what Minister Jaramillo himself has called that he is the pilot of health reform with the teaching and on the other hand is the issue of EPS interventions”Said the congressman.
For his part, Augusto Galán, director of Thus, we are in health and former minister of the portfolio, highlighted this means that a majority position in Congress does not see that the reform raised by the Government is what the Colombian health system requires, with the risk in addition to worsening the situation that is already being experienced.
“In addition, it does not solve the problems that the health system has. In addition to that, the structures they propose are a setback and as we have said, it does not particularly solve users and patients with an adequate access route to the provision of services”He said.
Galán also warned that the nonconformity that is being lived in Congress with health reform, may also be directed to the government seeking to impose its bill without negotiating it. “While that happens, it will be very difficult for this articulated advance”He insisted.
Likewise, the political analyst, Carlos Arias, stressed that there is nonconformity with the health reforms in Congress because the observations, requests and recommendations have not been attended, not only of the opposition congressmen, but of the associations of patients, medications and orphan diseases.
“There is another variable that has to do with the positions of this government around the Congress and around several opposition congressmen, where personal, ideological dynamics, policies of electoral interest with a view to the Senate elections in the month of March are mixed. That has caused many of the congressmen to resent the personnel and have political-electoral interests around the approval or discussion of the reforms“He confused.
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Experts warn that the definance of the system and the “intransigence of the government” are the main causes of the crisis.
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Affection in attention
Taking into account that the affectation of the system’s crisis has not only been for patients with rare diseases, but on the contrary is a generalized problem throughout the population, LExperts say that what is harming access to services, treatments and medications is due to the definance of the system.
According to Andrés Forero, to the discussion of the reform, It is added that more than half of the population today is affiliated with an intervened and controlled EPS by the national government, So instead of solving the problems of requests, complaints and claims, the guardianships or the portfolio problems, they have exacerbated after the intervention, which would show that the reform does not work.
“Beyond the issue of the discussion of the reform, which is affecting patients are bad administrative decisions in political terms that the government has taken, starting by defining an UPC that is insufficient. Those who end up paying the consequences are patients and in particular those who have high -cost diseases or those who have economic difficulties”He said.
Along the same lines, Augusto Galán stressed that the problem of attention is not so much because of the reform that is discussed in Congress, but by the structural definance of the health system. “Unfortunately this occurs with health systems when they are not properly financed and that dentitution generates a chain of illiquidity throughout the different agents of the system and repercussions at the end on the precariousness of the care many times, especially in the high -cost ones”, He concluded.
(See more: ACEMI warns a deficit of up to $ 33.4 billion per UPC underestimation)
Diana K. Rodríguez T.
Portfolio journalist
