Within the framework of the controversy that has been generated by the health reform presented in Congress, and by a letter from some ministers and the Director of the National Planning Department (DNP), the The Ministry of Finance published the figures that account for what it would cost to implement the health reform in the country.
(Read: Health reform: Petro will receive party proposals for changes).
In the document revealed by Cambio magazine and signed by the Finance Ministers, José Antonio Ocampo; the former Minister of Education Alejandro Gaviria; Agriculture, Cecilia López and the director of the National Planning Department (DNP), Jorge Iván González, the heads of the departments They make objections to the bill, especially the cost of the reform, the role of the EPS and the process as ordinary law.
Government officials mention that primary health care would double with the implementation of the reform, passing from $8.7 trillion to $16.9 trillion in 2023. Which would mean a fiscal impact of $8.1 trillion.
“The Ministry of Finance takes into consideration that the project under analysis, if sanctioned as a law, would have an impact on the Nation’s finances”, reads the document, which specifies that, with the proposed reform, spending on primary health care would grow, on average, $2.5 trillion each year.
As mentioned by President Gustavo Petro and from the same Treasury portfolio, this document was discussed between the signatories and technical members.
(See: Álvaro Uribe proposes popular consultation for the health reform).
Consequently, from the Treasury they published a new table of fiscal expenses of the reform. In the disaggregated it can be seen that only in 2024 the fiscal expenses of the project would be $9.04 trillion.
Of these, $5.49 trillion correspond to direct expenses, among which are the Primary Health Care Centers (CAP), the strengthening of the Public Network, infrastructure expenses, scholarships, information system and sanitation of hospitals. To which are added $3.54 trillion of contingent expenses, which they refer to as infrastructure and capitalization expenses of Nueva EPS.
On the other hand, the president met this Monday with some presidents of political parties and they agreed that the health system should be reformed, but he opened the door for them to “present proposals to modify the articles that they consider should be modified”.
What does it mean for the health system?
According to Cristian Vanegas, health consultant, those high fiscal costs in the development of the reform, “they are going to create a gap”, because on average, “per year there should be an additional $6 trillion to what current resources generate”.
(Read: Minister of Health defends the reform: ‘fiscal impact is low’).
Thus, the expert considers that “the more resources the Government requires to implement its health policies, the coverage could be affected or the quality deteriorated.”
One of the considerations of the Legislature, as Vanegas mentions, to have these resources is to “reduce costs with a single tariff and make more users pay” but adds that, “Neither the government nor the country’s economy can stand another tax reform to request these additional resources.”
Paúl Rodríguez, an economist expert in health, says that these fiscal costs show that “this reform is not viable, because it has a very high budgetary impact.” To which he adds that “it would be unsustainable and unconstitutional, because sustainability is a principle in statutory law.”
Germán Vargas Lleras will present a counter-reform
Former vice president and natural leader of the Cambio Radical party, Germán Vargas Lleras, A counter-reform to health will be filed today in Congress.
It should be noted that this group declared itself independent and has been one of the most critical of the projects that the Government has presented in the Legislature.
The reform with which intend to modify the health system in the country is no exception and, although the details of the document that Vargas Lleras will present are not known, he has expressed objections such as that the initiative could lead to the “disappearance or death of health insurance and its main agents, the EPS.”
(See: Petro responds to the objections of his ministers about health reform).
He questions that the Adres is in charge of auditing accounts and assuming functions carried out by the EPS, because this entity does not have “the capabilities to manage, much less to contain spending.” Additionally, he considers that the articles “bureaucratize the system.”
CLAUDIA M. QUINTERO RUEDA