All of these changes would be processed through a much shorter health reform project.
Photo: Mauricio Alvarado Lozada
The EPS and the National Government have just closed an agreement that gives way to a health reform. The dialogues have been developing for a few days, when the president Gustavo Petro announced that it was setting up a new negotiating table with these entities. During the morning of this Wednesday, the president, the EPS and the Ministry of Health met in the Palace to close the details of the agreement.
In the consensus reached, the EPS agree to become Life and Health Managers and they give up forming their networks, a red line that the Government has maintained since the debate on how to reform the current model began. (Can see: Diagnosing and treating a rare disease: a great challenge)
The EPS would become Managers and their function would be mainly in medium and high complexity services, for which they would have a UPC differentiated from the primary care UPC, which would go mainly to the Primary Health Care Centers (CAPS). In this way, the Government would seek to guarantee a much more focused approach on primary care. At that primary level, the agreement would seek prohibit any possibility of vertical integration, another of its red lines.
All of these changes would be processed through a much shorter health reform project. As we explained a few days ago in these pages, this new reform would have a smaller number of articles (there would be around 50 items) than the original project. This article would focus on bringing the transformation points of the EPS to Managers, in addition to some articles to strengthen primary care, the formation of provider networks, a digital system, and the formalization of human talent in health.
The agreement was confirmed after 8 pm this Wednesday. In the statement, signed by the main unions (Acemi and Gestarsalud) as well as by the heads of the EPS Sura, Nueva EPS, Salud Total, Compensar, Mutualser and Coosalud EPS, it is noted that they present a proposal that reflects a “concerted transformation.” . “Naturally, this proposal for a new health reform will be enriched with the contributions of the other actors in the system, especially patients, health personnel, health service providers, once it is presented for subsequent debate in Congress.”
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The consensus, the statement continues, takes as its starting point the “extensive conversation” sustained from the original project that sank a few weeks ago. The EPS, the unions and the Government will continue in conversations starting May 2 “about the current financial situation of the system.” This point is key: the EPS have maintained that the system is in crisis due to the definancing of the UPC (the money that the State gives them for the health care of each member). The Government has denied it.
“After the work sessions with the EPS, the criteria for transforming them into Health Managers, their role and responsibilities in the health system were agreed. “This reflects a concerted transformation that will be presented to Congress for discussion in the coming days,” the president said.
The agreement between the EPS and the Government had been under wraps for a few weeks. On April 12, some six of these entities (Mutualser EPS, Coosalud, Salud Total, Capital Salud, EPS Familiar de Colombia and Cajacopi EPS) that affiliate more than ten million people in the subsidized regime had announced their support for a reform. “We have specified what our functions will be. We want to tell this to the country so that the discussion is opened to patients, political parties, associations of clinics and hospitals, so that we can make a pact for health,” added the spokesperson for these EPS.
That statement precipitated the departure of Carmen Eugenia Dávila from the presidency of Gestarsalud, the union that brings together the EPS of the subsidized regime, a function that today would be in charge of Galo Viana, leader of Mutualser EPS. (Can see: If the health system is underfunded, where is the money going to come from?)
