Decree 0858 of 2025, through which the Government adopts the so -called “predictive and resolutive health model”, He received a hard criticism from a group of former minister and exviceminists of health and social protection.
The signatories warn that the norm implies a structural transformation of the system without going through the Congress of the Republic, without having technical or financial support, and without guaranteeing the principles of legality and sustainability.
(See: Patients, on the tightrope for new decree in health)
“It is a de facto reform that replaces fundamental pillars of the current health system without due democratic debate”, Said the former officials in a joint pronouncement.
The concern focuses that, after several failed attempts to process a reform in Congress during the last three years, The Government has opted for a decree to redefine the foundations of the care model.
According to the group, the expedition of the decree violates the principle of division of powers and omits the necessary political and technical control. “The Government has decided to advance in the transformation of the system administratively, without a broad, participatory and plural legislative debate”, They say.
(Read more: They warn risks in care of patients with new health implementation)
Former ministers and exviceminists warn that the standard lacks technical studies, clear financing and viable deadlines.
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From its perspective, Decree 0858 does not represent a solution to the system crisis. Instead, It introduces institutional, operational and financial uncertainty, by substantially modifying the role of EPS, weakening individual assurance and moving key functions to territorial entities without proven capacities. “Responsibilities are imposed on structures that still do not exist and deadlines are set without operational or financial viability,” they said.
Regarding the technical formulation of the norm, they questioned the absence of actuarial studies, fiscal impact analysis and institutional capacities evaluation. They assured that the new model develops without evidence that supports its viability. “There are no transparent technical studies, nor is a clear source of financing presented. UPC still does not guarantee sufficiency to meet the needs of the system”They pointed out.
They also indicated contradictions between the content of the decree and current legislation, such as Laws 1122, 1438 of 2011 and the 2015 Statutory Health Law. They warned that the proposed model can represent a risk similar to the collapse of the National Fund for Social Benefits of the Magisterium (FOMAG), if applied without the required legal and institutional scaffolding.
(See also: Supersalud asks for clarification and partial nullity of court ruling in EPS Sanitas)
The group requested the State Council of precautionary measures to suspend the application of the decree while evaluating its legality.
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Despite recognizing the importance of components such as primary health and quality care, former officials consider that these principles cannot be implemented through a standard that “disrupt the basic balances of the system without building a functional alternative”
Before this panorama, They called on the State Council to take precautionary measures that stop the entry into force of the decree until its legality is pronounced. They also urged the Congress of the Republic to exercise their legislative and political control function. “We demand that Congress assume its historical responsibility and promote a technical, open and independent expert participation,” they said.
Finally, the group urged the Government to resume democratic and technical dialogue as a route for structural reform. “The health of 50 million Colombians cannot be based on ideological impositions, but on scientific evidence and institutional responsibility”, They concluded.
(See: Scientific societies will participate in the technical structuring of the UPC)
Diana K. Rodríguez T.
Portfolio journalist
