In an interview with EL COLOMBIANO, the outgoing president of Fiduprevisora, Mauricio Marín, attacked the Minister of Health, Guillermo Jaramillo; He says that he was completely unaware of the sector’s tariff and that for this reason the crisis broke out in the teachers’ system.
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What happened for you to visit the Palace, have a meeting with President Petro, even bring results on the corrections to the new teacher model and one or two days later you resign from the Fiduprevisora board?
“I think it is very important to make public opinion aware that the health model, adopted through agreement 003 of 2024 by the board of directors of Fomag, in a board of directors chaired by the Minister of Education, also made up of the Minister of Treasury, the Minister of Labor and two Fecode delegates; It is a model in which we have been working, however, Fiduprevisora receives the instruction to begin hiring and deploying its technical capabilities on March 27 of the current year and the agreement of the board of directors is dated April 1.”
In this way, obviously different technical obstacles were encountered in order to move forward with the implementation of the model. The board of directors and Fiduprevisora agreed, they found absolutely all kinds of strategies to be able to quickly resolve what were the traumas in the implementation and the outcome is fundamentally due to the fact that the technical assistant of the board of directors is the Ministry of Health and they were developed some serious technical differences that are not from the last 15 or 20 days, but come from a long time ago and in this way, therefore, when one wants to build a technical career as is the case itself, one also has to have the professional maturity of knowing when to say no, when to say stop and when to know that the technical obstacle is one.”
There were protests by teachers in Medellín, Bogotá, Boyacá, Atlántico and many regions because once the model proposed by the government began it was a failure, who is responsible for that?
“All implementations of any decision happen thanks to the legislature of Law 9189, which approves all contracts and all strategies implemented through the board of directors. This collegiate body is the one who gives the Fiduprevisora the fiduciary instructions, that is where the responsibility lies, the Fiduprevisora must remain internal and that is also a message that I need to convey to public opinion and that is that the Fiduprevisora is an executing entity. Whoever sets the strategy, who gives the line is the board of directors.
Now, in terms of the collection of the network and in terms of the collection of the contracting, there were many problems, initial problems due to a tariff that the technical assistant put on the table to begin collecting the network and this tariff, well It had ridiculous prices compared to market prices with health services that were quite distant from reality.
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I’ll give you an example: an appendectomy that in the general regime is $2,800,000, for the teachers’ rate it was initially raised at $1,500,000. The appointment with a transplantologist is raised in the general regime at 1,090,9000 for example, and for the teachers’ regime it is less than 100,000. In this way, the IPS, making logical use of their negotiating conditions, began to distance themselves and many began to say “I don’t serve the teachers.” What was done? Well obviously we did not fight with all the IPS, but we made the technical assistant see his mistakes. However, we did not stop at making them see the errors, but rather we ignored the tariff and began paying market rates through circular 002.”
Why did the Ministry of Health have no idea about the rates?
“I have no idea. Well, the truth is something that absolutely escapes my knowledge. Today I already have a lot of gratitude as a Government official that I was until yesterday. I am convinced that the teacher health model, once implemented, will be a great model. The other big discrepancy is on the issue of cost-effectiveness of the model. Because Fiduprevisora raised her hand and said this so that it is cost-efficient and lasting over time.”
But, does that mean that the minister came one day and set some rates and told you: no, you have to pay this much and badly?
“As it is. But obviously when criteria and technical careers are built, no matter how many fiduciary mandates are given, we have to move away. We are not paid to do cases, but to think, to advise a Government, to advise a board of directors and to implement solutions that serve Colombians, in this case, teachers. Not by following ideas from some portfolio.”
The teachers went for these services and the clinics told them no?
“Well no, obviously, because they were going to lose money.”
In the recordings in which you argue with Minister Jaramillo, you tell the minister that the President had given them the order not to contract with some clinics and hospitals. Why did the president order that?
“The expression was not to contract medications directly with IPS at the first level. And the spirit of the model is to eliminate intermediation in all its phases.” So, a solution that the minister proposed in those conversations is that medications be contracted with the IPS from the first level. That is what has been fought for so much and so much has been fought and that is that first-level IPS intermediate the medications. So, what I expressed to him is, “man, this was already a discussion and this is not going to be done because we have to eliminate intermediation,” to which he said, “no, we’ll fix it later.”
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Do you resign because you have an irremediable technical difference with the minister of health?
“As it is. “I doubt the technical solvency of the Ministry.”
Or the minister…
“I stick with the first comment.”
What should the Government do to definitively correct the problem of the teachers’ system?
“In my opinion it is time. With the correctives that are already there, with the instructions that are already given, the system is quickly parameterized. The network has schedules that are set until the middle of this month to finish stabilizing the network. So I believe that time, data governance and the interoperability of the clinical history and each of the components that were promised to the teachers are going to begin to have results. But I believe that it is with results that we have to come out, not with harangues or being caustic with some sectors of FECODE because that ends up doing more damage to the model.”
Are you concerned that Minister Jaramillo is leading the reform?
“It worries me, not as an official, but as any Colombian. However, I think it is a bit hasty to say something. We have to wait, see the reform, read it, study it and see that it is not a PowerPoint presentation. Without seeing that, like any model, it is cost-effective and has durability over time.”
There are those who say that the person in charge of coordinating this change of model was Fiduprevisora, which until now is a failure, it was you. You don’t take any responsibility?
“I have to be emphatic that the model is not a failure, it is a model that has had serious difficulties in its implementation, with traumas that will be overcome by addressing them in a technical way, as I said, without populism, without harangues. I assume responsibility for having given the best advice to the board of directors. At the time, the flags, the red lines, were put up. When I had to raise my hand, I raised my hand, and when I had to deviate from a criterion as shown in the letter I sent to the board of directors. I am a guy who considers myself to have convictions, you simply have to step aside and know what fights to give and what fights not to give.”
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