The year 2024 closes with an unprecedented crisis for the health system in Colombia. Thousands of patients, mostly with chronic or orphan diseases, They have lost the treatments they received periodically and in a timely manner.
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Complaints, petitions and appeals for protection have grown alarmingly, with increases of more than 30% and 40% compared to 2023, while opportunity in access to health services deteriorates day after day.
According to a letter sent by former ministers and former vice ministers of health to the current portfolio, the financial outlook is also bleak. In 2024, more than 1,200 IPS closed their doors due to insufficient resources, leaving more than 3,000 medical services permanently closed and another 8,000 temporarily suspended.
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Added to this is the intervention of eight EPS by the National Health Superintendency and the placing of one more under special surveillance, evidencing a systemic financial problem with property losses that areThey exceed $7.5 billion, not including the balances of the New EPS.
The definancing of the Capitation Payment Unit (UPC) and the maximum budget aggravates the situationprojecting a deficit of more than $5.5 trillion by the end of the year. In this context, the National Government, headed by the Minister of Health, has opted for a speech that many consider evasive and confrontational.
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They assure that far from assuming responsibility for this crisis, The minister has denied and distorted the reality of the sector, while appearing focused on political aspirations. This behavior not only minimizes the achievements of the last 30 years, but also ignores citizen support for the system: according to a survey carried out by the Ministry of Health itself in 2022, only 8% of the population rated the system as bad or very bad.
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Since 1992, The health system has achieved almost universal coverage, going from 23% to 100% of the population, and has doubled public financing, which grew from 2.6% to 5.8% of GDP.
This progress, they indicate, was based on principles of solidarity and efficiency, materialized through the UPC, and allowed benefit plans to be equalized between the contributory and subsidized regimes, promoting greater equity in access to health.
(See: Sura EPS responds to the Supersalud decision on its progressive dismantling)
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The system also significantly increased access to services. In 1992, one consultation was carried out per citizen per year, while in 2022 this figure exceeded 4.5 consultations, generating millions of procedures, interventions and treatments, even in a context of population growth of 56% since 1992.
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The main beneficiaries of these advances have been the most vulnerable populations, which reaffirms the importance of preserving and strengthening the system.
Despite these achievements, The Government’s decisions have put the progress achieved at risk. Instead of addressing the structural difficulties of the system, such as the insufficient supply of services in the face of growing demand, it has been decided to intervene and transform the agents that manage demand, an approach that has exacerbated access problems and deepened the crisis.
(See: Financial risk of public IPS: more than $12.4 billion in portfolio and growing deficit)
The pandemic and post-pandemic exacerbated the challenges, but instead of strengthening infrastructure and the supply of services, The Government has promoted a reform project in Congress that does not solve the structural problems, they say. This lack of technical focus has led to a worsening of access indicators and a general deterioration of the system.
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César Melgarejo / Portfolio
According to former officials, the current situation requires a change of course. The advances of the last 30 years were not achieved with ideological discourses, but with constant work, decisions based on evidence and respect for constitutional rights.
(See: Crisis of the health system: the dangers of defunding and deterioration in care)
“It is urgent that the Government promote a frank and transparent dialogue, based on evidence, to build a State policy that guarantees the right to health and well-being of Colombians.”they say.
If we continue with the current approach, The health system could face even further deterioration in 2025. Now, collective interest must be prioritized over partisan affiliations and work together to preserve and improve a system that has been fundamental for equity and the social development of the country.
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