From May 1 The health system for teachers and their beneficiaries will have a significant change in its model, after a negotiation between the National Federation of Educators (Fecode) and the Ministry of Education.
The new system is very similar to the reform that was sunk in the Congress and its final objective is to eliminate financial intermediation and strengthen control mechanisms. In addition, Fiduprevisora would continue to manage the system’s resources, but would also begin to manage the money of the National Fund for Social Benefits of Teachers (Fomag).
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However, some of the announcements have generated a series of doubts and uncertainty, since until today, it is not known how the new model would be carried out. Also, the Investigative Unit of EL TIEMPO revealed that before the Administrative Court of Cundinamarca A protection action was filed that seeks to stop the agreed initiative.
Now, experts pointed out that the doubt should be raised as to whether Fiduprevisora will be able or has the power to manage the new model.
Teachers
In accordance with Jaime Arias, former minister of the portfolio, former director of Social Security and former president of Acemigovernment “sows uncertainty in what touches”. She said that it should be taken into account that the Fomag has been surrounded “Alleged corruption in contract hiring”.
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“It is said that the care of 800,000 people could cost close to $18 billion a year, that is, 20% of what the general health system that serves 50 million members costs.“Arias stated.
Along the same lines, experts consider it a mistake to abruptly suspend the bidding process that Fomag had been carrying out through Fiduprevisora, within a model that allowed the integration of a network and health risk management.
Teachers iStock
This is what he assured, Jesús Albrey González, president of the Medical Law Bar Associationwho also noted that “Now, two days before the new proposed model begins (direct purchase of services), the country, the network, and the teachers are not clear about how it will operate, and that is serious, because the continuity of medical care”.
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Also, another point that alerts is that Fomag has had a model similar to the one that the Government sought to impose at the time it proposed the health reform bill for the General Social Security Health System (SGSSS).
According to the director of This is how we go in health and former minister of the portfolio, Augusto Galán, this negotiation maintains a nationalized system in its management, due to Fiduprevisora and ministries of education,with a single payer Fund through concessions managed by sections, with contracting of private providers”.
Teachers iStock
According to Galan, This system has not been effective and in fact spends more per person per year than the SGSSS does.despite which it has a higher PQR rate per member than the SGSSS insurers.
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“It is doubtful that the situation will change with the proposed reform. There are some minor, almost cosmetic reforms, related to the care model, which aim to emphasize what the government calls the predictive and preventive model.”, he mentioned.
He added that for a few years now, Fomag has had a higher per capita income than the system has, and as mentioned “Everything seems to indicate that the money is not enough for them.”.
Is Fiduprevisora capable of managing?
Although the model has already been defined and would come into force as of this week, experts assured that there are doubts about the capacity of the Fiduprevisora to manage everything the system needs for the country’s teachers.
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It is worth detailing that within the Fecode announcements it was established that this entity would be the administrator of the national service network and in addition to the Fomag resources.
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In this way, Jaime Arias, recognized that the “Fiduprevisora has no experience as a health insurer. The president himself being the one who warns about risks of corruption in the system of his Fecode allies”.
For his part, lawyer González pointed out that the Trustee in the past “has awarded the tenders to operators, but many of the functions of the operators that they assume today are new and there may be serious traumas, especially in guaranteeing the continuity of care for teachers”.
DIANA K. RODRÍGUEZ T.
Portfolio Journalist
