After two years of the current Government, the members of the Pact for Better Health made up of users, patients, insurers, health service providers, health professionals, the pharmaceutical sector and leaders of the sector, They wrote a letter to the Government expressing their concern about the current health systemwhich in these last twenty-four months has presented challenges and difficulties.
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In the document, they highlighted that care for the general population continues to deteriorate. According to them, monitoring of access to the provision of services shows that services have been closed in some clinics and hospital institutions with a reduction in available beds in intensive care units and specialized care; Requests, complaints, claims and suggestions (PQRS) from users and patients increased by 17% when comparing the first four months of 2022 with the same period in 2023 and by 11% between the latter and the same four months of 2024.
“Health care requests have grown by more than 40% when comparing these same periods and as a consequence of the greater difficulties in accessing health services; the shortage of medicines that patients had been receiving regularly has not been corrected and is getting worse. Finally, reports from the High Cost Account (CAC) record a growth in patients suffering from these diseases, much higher than any trend that has been presented in the past.”they point out.
On the other hand, all the lending associations have spoken out about the low collection and the growth of the portfolio and have requested effective liquidity strategies from the Government, which they say have not been addressed.
“The above, together with the interventions carried out in EPS by the National Health Superintendence (SNS) and the withdrawal requests by others – which in total add up to 34 million members of the Social Security System in Health (SGSSS) – demonstrate the depth of a problem that affects citizens which has not had an effective solution by the national government. These EPS maintain a growing financial deterioration as of March 2024,” manifest.
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They point out that the structural underfunding that the health sector suffers as a result of the evil
calculation of the capitation payment unit (UPC) and the deficit in funding of the maximum budgets to cover unpaid care with the UPC, explains the genesis of these difficulties that the health system is going through, which affect its entire value chain and have not been addressed by the government despite the repeated calls and warnings made by patients, users and academic sectors and think tanks that monitor these aspects.
“The government has not fully complied with Rulings A2881 and A2882 of 2023, made public in the first months of this year, by which the Constitutional Court ordered it to catch up with payments to the EPS for overdue debts from the years 2021 and 2022 for maximum budgets and recoveries. To this must be added that in 2023 debts for maximum budgets of the national government to the same entities materialized,” they say.
On the other hand, they are very concerned about the public response given by the Deputy Minister General of the Ministry of Finance to a representative of the House in recent days, when he asked about the disbursement of these debts and the answer was that “The allocation of resources for the payment of maximum budgets will be carried out once the Nation’s income shows an adequate behavior that allows the allocation of the same in the terms of article 153 of Law 2294 of 2023.” In short, there is no money to sufficiently pay for the health of Colombians.”
As highlighted above, the national government has not fully corrected its own diagnosis established in the communication of March 20, 2024 in a letter addressed to the president of the 7th Senate Commission by the Vice Minister of Finance María Fernanda Valdés Valencia. In said report, the Ministry of Finance indicated that, for this 2024, there was at that time a Lack of resources of $5.9 billion pesos to finance the UPC and the PM.
“By the end of 2024, according to the trend in the use of health services that has been occurring, a deficit of 2.3 billion is estimated for UPC, 2.7 billion for Maximum Budgets and 800 billion for SOAT claims,” indicate.
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In addition to this, in the draft review of the General Budget of the Nation for the year 2025, they are concerned about the deficit of close to $3.6 billion pesos for the health system. According to them, taking as a scenario the historic growth of the UPC of the last five years. This deficit could be higher by $2.5 billion pesos if the national government does not make a budgetary transfer of resources that are currently lacking to close the health insurance for the year 2024, they say.
“The response to the huge setback that the health system has had during these last two years is the uncertainty generated in the sector by the national government due to the lack of effective management to solve it and the insistence on presenting again the same health reform project that was archived in the Senate last April. The drafts that have circulated on a bill text supposedly coming from the national government – which closely resemble bill 339/2023 presented by the latter in the last legislature – have not been discussed or analyzed with the majority of the agents of the system,” they assure.
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They conclude by recalling that the project did not solve the challenges facing our health system, it was not designed to benefit users and patients, it focused on modifying the functions of some entities and eliminating individual protection of health insurance and other advances acquired by the Colombian population in the effective enjoyment of the right to health.
BRIEFCASE
