They urge not to throw away the public-private experience in health

The discussion on the new health reform filed before Congress continues to heat up, especially due to criticism of the project, which many of the actors in the sector consider to be It is very similar to the one that collapsed in the Senate in the last legislature.

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While the importance of strengthening the public part of health is highlighted, most experts agree that The private sector should not be neglected, who are the ones who today are “guaranteeing” service and attention to all Colombians.

Broadly speaking, most health experts agree that This new article lacks agreement and dialogue between actors and that the Government once again submitted a bill “in its opinion.”

(Read more: Scientific societies question that health reform was carried out ‘behind closed doors’)

Even Agamenón Quintero, president of the Colombian Association of Scientific Societies (ACSC) assured that A new concern is added by the text’s inclination towards strengthening the country’s public network in a country where 80% or more of services are provided by private entities.

For the union leader, insist on a strictly public system and turn Adres into a multi-purpose entity with powers that it will hardly be able to exercise even in the medium term, generates uncertainty about the present and future of the health system.

(See also: What is the status of the EPS that is in the process of withdrawing from the health system?)

Now, according to the director of Así Vamos en Salud and former minister of the portfolio, Augusto Galán, lWhat the country needs is to further integrate both sectors, Considering that at least only the public sector needs a specific strengthening of the institutional capacity of the sector, that is, in hospitals, health centres and posts.

“This requires separating public health from the partisan exercise of politics in Colombia. In other words, this partisan influence generates a pressure that is often not positive for the development of the sector and particularly for the strengthening and improvement of hospitals in terms of their quality and operational excellence.“, Galan said.

(Read also: Were health sector stakeholders taken into account in the new reform?)

He added that this is an aspect that must be worked on together, precisely so that the affiliated citizen, regardless of the sector to which he belongs, has timely and effective access to health care or services with quality.That is the work that we must continue and not try to continue dividing ourselves between one or the other being better. That is not the way.“, he said.

In turn, Paul Rodríguez, professor of economics and health expert at the Universidad del Rosario, highlighted that in the current system, Health Promoting Entities (EPS) and the Secretariats have a role that overlaps with public health. For this reason, the new initiative seeks to generate a territorialization of care.

(See: Former ministers and vice ministers of health reaffirm concerns about the reform)

However, he warned that the challenge with the new proposal is that the connection between the CAPs and the EPS or managers is weaker than is evident today. “Sand care is fragmented a bit and that means that even if things are identified quickly, the movement of patients up the health network is slower.“, he clarified.

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And what about the private?

In this discussion about the health system, one of the points that comes to the fore is precisely the “important” role that the private network has within the sector. According to Galán, one of the focuses that cannot be lost sight of is the issue of insurance, and he also considers that it is a waste to leave aside the private sector when it has been shown that it is “more effective.” because it has greater capacity for changes and is more agile from a procedural point of view.

(See: Adres suspends transfers of more than $70,000 million to allegedly non-existent IPS)

“The public sector is somewhat more pachydermic and bureaucratic and this prevents it from acting with the appropriate speed to incorporate the new developments that are taking place in the administration in general and particularly in the administration of health and in the effectiveness that will be had in serving patients better and more quickly.“, he said.

For this reason, he considered that this is one of the risks that are run by leaving aside a 30-year public-private alliance, Because it represents wasting an experience, a knowledge, a trajectory that is not recovered, nor is it built so easily.

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Likewise, Rodriguez explained that the private aspect within the whole story is linked to the fact that it is this sector that receives the remuneration of the offer, which is why the “great danger” It is the way in which it is being contracted.

(See more: What does it mean that the health reform will be processed as an ordinary law?)

In this regard, he added that there is a risk in terms of contracting, Considering that the process may be slower, so the form could be worse than what exists today for some hospitals.

“With this new version of the reform, we are thinking about how the discussion will be, what will happen when it is implemented, what controls there will be on the contracting model that the manager makes when transferring a patient who comes from the CAP to another area. There is a great risk in the proposed model, not in the specific reform of this text, and that is that the EPS loses that great incentive to control the care of each patient.“, Rodriguez said.

(Read also: Health reform: key points of the new bill submitted to Congress)

It should be noted that according to the president of the ACSC, the presentation of the reform, in the way it was done, shows that the content of the project does not respond to a consensus, nor does it reflect the proposals made by key sectors of the sector.The differences presented by the holder of this portfolio are not minimal, they are of form and substance.“he concluded.