New health model for teachers: a major failure

New health model for teachers: a major failure
New health model for teachers: a major failure

In the same way, Arias pointed out about the future of the new health reform: “The lack of judgment, knowledge, coordination and direction on the part of the Government was uncovered, as heard in the audios of the Minister of Health. Now they say that in a couple of days they will solve a service network problem, which for the best EPSs takes months or years. On the other hand, Minister Jaramillo said that this would be the model for the great health reform, which shows his folly and lack of judgment about how health insurance systems work. “All chaos.”

On the other hand, the Former Minister of Health Augusto Galán commented on the matter: “This improvisation is unfortunate, which is the product of the desire to make changes in an accelerated, possibly abrupt manner. From trying to bring your proposal to execution as quickly as possible and that does not work, simply because they implemented a new health model that is not a topic for a weekend, or things like that, that requires a lot of preparation, prior review , planning, experience and knowledge.”

In the same way, he warns: “There is too much anxiety to impose and change based on ideological aspirations, surely similar to health system models in other more developed countries. But experience also shows that it takes years to implement, that it does not happen overnight. So, I believe that the chaos comes from that error and the scandal that resulted is only natural to the extent that many expectations were surely generated for the teachers and those expectations have not been satisfied and on the contrary what is being seen is a great setback in what in itself did not work properly and had to be modified and improved, but that is not the way.”

Finally, the former official said: “I believe that the minister’s own statements at the time, when they began the implementation of the teachers’ health model and said that this was the pilot that they wanted to implement as a health system throughout the country for all Colombians , show that if they have these difficulties with a teacher health fund that has 800,000 members, what are the challenges and their magnitude when trying to do something similar with 50 million Colombians. You can’t improvise on that and that was a wake-up call that we had been pointing out for a long time. Here you cannot rush, you cannot impose things, this requires planning, analysis, defining clear objectives as to what you want best, and what has been evident is that you want to assume certain roles, change an institutional framework. , manage the financial resources of the health system, but in the end one is not thinking about what is best for the users, the patients, what they need and how, in light of those needs, decisions are made to improve the health system without put an end to the progress that has been made over these 30 years.”

ANIF warns that the new model failed

A report from the ANIF Center for Economic Studies revealed that the failures in the teachers’ health system are evidenced by the distribution of its 820,000 members in the main regions of the country where coverage was lost. “By the end of 2023, this fund had 818,960 members, with a prevalence of women and people over 50 years of age. If only new affiliations are evaluated for that period, 42,863 new people were reported in this system, of which 63.7% are concentrated in departmental and district Secretariats of Education.while the rest are located in municipal secretariats. This means that more 50% of affiliates are concentrated in five regions: Bogotá (28.5%), Cundinamarca (6.5%), Atlántico (5.7%), Antioquia (5.3%) and Santander (4.3% )”.

Likewise, the entity highlights: “As the Government expressed in the reform presented to Congress, the new model seeks to eliminate intermediation in the provision of services. Under this premise, it is intended to establish a National Service Network for Fomag, which claims to integrate a greater number of suppliers, which has not been achieved, because since the entry into force of the new model, more than 2,100 complaints from users, that is, more than 110 complaints daily associated mainly with the cancellation of appointments and surgeries, and the interruption in the delivery of vital medications for diseases such as diabetes, HIV and cancer, to name a few. This has left the implementation of the system a failure.”

Research

These are the investigations that have been opened by national entities for irregularities. The Attorney General, Margarita Cabello, announced an investigation in this regard: “The health of approximately 1 million teachers is at risk as of May 1, due to the change in the care model proposed by Fomag, and we will proceed with the immediate actions that may be necessary.”

For its part, the Comptroller’s Office stated in reference to the health system: The Comptroller General of the Republic began a concomitant and preventive control over the process of the new Fomag model. This control will be carried out by an intersectoral action of the delegated comptrollers for Public Management and Financial Institutions, Education and Health.”

In the same sense, the Health Superintendence also explained that it will take measures in this regard: “The Superintendency ordered a precautionary measure against Fiduprevisora ​​and Fomag, after receiving more than 2,100 complaints from users who were unable to access medications and services from the health providers.”

A group of congressmen led by Jénnifer Pedraza, Cathy Juvinao, Daniel Carvalho, Alejandro García, Julia Miranda Giraldo, Cristian Avendaño and Carolina Giraldo, among others, presented a motion of censure against the Minister of Health and Social Protection, Guillermo Alfonso Jaramillo Martínez, in the House of Representatives, as a result of the complaints about the teachers’ health system scandal and the confrontation with Fiduprevisora.

Finally, Congress listened to the president of Fecode, José Domingo Ayala, who said: “We are not governed by the EPS as stated in Law 100 of 1993 and we looked at a formula in which IPS or service providers would come together and that was generating some operators and that is where there is intermediation between the operators that subcontract with the IPS and we begin to eliminate intermediation, which is where the problem is occurring, because the Government orders the elimination of intermediation.”

 
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