In a week full of ups and downs for the health sector, it was learned that the government will once again try to promote a reform of the system. After the complex step that the previous initiative had, which collapsed in the Seventh Committee of the Senate a few weeks ago, The Executive would have a new article agreed upon with different EPS, whose filing would be scheduled for May 1, according to EL TIEMPO.
(Also: The EPS speak out on the new health reform proposal agreed with the Government).
Previously, six EPS (Mutualser, Coosalud, Salud Total, Capital Salud, EPS Familiar de Colombia and Cajacopi) had publicly stated that they wanted, of their own volition, transitioning to the Health Managers model that the government had proposed in the project collapsed on April 4.
In fact, Galo Viana, the leader of the EPS Mutualser, said on behalf of the six entities gathered in Cartagena on that occasion the following: “We recognize, and we have made great progress in long conversations with the Ministry of Health, with the senators of the “Historical Pact, of the U, in wanting to transform ourselves into Health and Life Managers, and in wanting the health reform to advance.”
Hospital.
Photo:Valley Governorate
At this point, of the 51.74 million people covered by the system (cut to August 2023), the State would be in charge of caring for 26.63 million users (51.4% of the system). Action that would lead other entities under pressure such as Compensar EPS to request its total liquidation from Supersalud, just a couple of days later.
For this reason, analysts and politicians in the sector assure that the EPS seem to have given in to pressure from the Government. The congressman of the Democratic Center, Andrés Forero, assured that the meeting was held “behind closed doors” and without the participation of patients, doctors and academics.
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“The government of Gustavo Petro has agreed on a health reform text with the EPS, which it criminalized a few weeks ago and which it managed to subdue due to threats from the Health Superintendency. According to the text that has been leaked, it is possible to identify that it is a sweetened version of the reform that was sunk in the Senate of the Republic and that for that reason we could not accompany, because our commitment is to Colombian patients. And I wish the EPS had learned from what happened to the liberal senators with the pension reform and understood once and for all that pacts with the devil never turn out well,” he said through a video.
It should be noted that despite the synthesis work, this new article has not been well received by analysts, patients and academics in the sector who consider that cWith this new proposal, the public-private insurance model will end, leaving the functions in charge of the State, without being precise about who will be responsible for making access to health services legitimate and how the financial risk for care will be assumed.
If the new articles are approved, the EPS will have only two options: become Managers or withdraw from the system – for which they will have 60 days if the new reform is approved. If the EPS does not express either intention, it will immediately begin the withdrawal process.
Denis Silva, spokesperson for Patients Colombia, the movement that brings together more than 198 user organizations, stated that they feel disappointed with the EPS. “We have been fighting and exhausting ourselves for 17 months to maintain the current insurance model and, seeking individual well-being, they agreed to join the reform,” he said and assured that the proposal for the new role of the EPS does not have any major changes compared to the first. project that sank in the Senate.
This is a problematic scenario with which several former health ministers agree, such as Jaime Arias, Augusto Galán, Fernando Ruiz, Alejandro Gaviria, among others, who through a letter have demanded that these negotiations take into account the participation of other agents. of the system.
“We have always expressed our willingness to seek consensus within the framework of a true democratic dialogue. We have not received a response and the way these new conversations are developing are exclusive and segmented; which contradicts true citizen participation in a transcendental issue such as the health of citizens and the changes that improve the system that regulates and protects this fundamental right”, They assured through a letter signed by at least 20 former ministers of the sector.
HEALTH SYSTEM PATIENTS.
Photo:ROGER URIELES / TIME
“It does make it easier for EPSs to become managers (it gives continuity to a business). However, it does not resolve the major concerns about sustainability (it generates more spending without clear sources of resources), about the patient’s path (which will adrift), on the fragmentation between primary care and more complex care and on the incentives for adequate management of resources,” he explained.
For its part, the Pact for a Better Health System movement, which brings together academics, patients and scientists, ensures that The new reform project does not speak clearly about how the progressivity of the fundamental right to health will be guaranteed, the financing of the General Social Security System in the future and the comprehensive, articulated and timely access of users and patients. to health services and required treatments.
“With the transformation of EPS to Managers, the problems that the Health System has today are not resolved. The above leads us to ask ourselves crucial questions such as: What is the future of patient insurance? Will individual protection be guaranteed and will Will social security in health be compromised in Colombia?”, they stated.
Although the date of filing of the articles would take place the week that begins, The entire health sector has asked the National Government to create inclusive and constructive spaces before filing the reform project.
in the Congress of the Republic.
“We want all the voices that make up our Health System to be recognized, especially those of organized civil society. Patients, we recognize all members of the pact, are the center of the discussion,” emphasized the movement For a Better Health System. .
