The sustainability situation of the Colombian health system continues to go from bad to worse, because although the lack of funding of the system is generally known, The truth is that this problem is compounded by new pressure on account of the resources for this year’s maximum budgets, which are the mechanism for recognizing treatments for high-cost diseases.
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According to the Así Vamos en Salud Financial Observatory, only by July 2024 the Administrator of the Resources of the General Social Security System in Health (Adres) 100% of the funds allocated for this purpose have already been allocated, which will require an additional budget to cover the following months.
In general terms, for the seventh month of the year the total execution of the resources destined to cover the services and technologies not financed with the Per Capita Payment Unit (UPC) was $1.58 billion, which implies that 100% of the budget has already been allocated.
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“It is important to note that some of the technologies and services that were previously funded by maximum budgets are now funded by the UPC. However, the system still faces challenges in meeting the total amount of necessary expenditures, especially in the case of drugs for orphan diseases.”, says the Observatory.
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Difficult outlook in 2024
That said, according to the Así Vamos en Salud study, the value for the maximum budgets for 2024 amounts to $1.58 billion, where according to the Adres liquidation process, The remaining $254 billion are pending application for direct transfer, as defined in decree 489 of 2024.
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For this year, they reiterate that EPSs have not yet been recognized maximum budgets for 2024“which means that the administrative acts for each of the entities establishing the maximum budget allocation for the entire term have not been issued.”
At the end of July, it is shown that there is a definitive appropriation of $1.83 billion for the payment of this year’s maximum budget, which indicates that it has already been fully exhausted and there will be no resources available for payment of the current term.
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On the other hand, according to the financial catalogs of the EPS, published by the Superintendency of Health, corresponding to the second quarter of 2024, Costs associated with maximum budgets are $1.18 trillion.
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“It should be noted that the report of the New EPS, which is currently the largest EPS in the country, was not identified in the financial catalogues published by the Superintendency. Therefore, it would be expected that the maximum budget value would be higher.”, they indicate.
They add that It can be observed that in the Adres expenditure budget as of July 2024 there is a final appropriation of $1.93 billion, of which 57.1% has been executed.which would require the use of $830,000 million. “In this order, it would be understood that as progress is made in collecting income from Adres, the remaining amount will be available to execute said resource,” they say.
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Past validity periods
Now, the concern increases especially because the actors of the system have expressed the debt that the Government has with the payment of the maximum budgets of 2022. Although $2.21 billion have already been paid for that year, A total of $750 billion remains to be paid to cover that year’s collections.
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“At this point, it is relevant to note that the estimated recognition of the maximum budget for said period is in the order of $2.9 billion, so to date the entire maximum budget of the EPS in both regimes has not been transferred to the system and a transfer of around $750,000 million would be needed for the 2022 period.“, they analyze.
It should be noted that the representative to the House, Andrés Forero, had already denounced that the Minhacienda will not be able to pay those resources for 2022 this year, as a result of failure to meet tax collection targets in the first quarter of the current year.
Even in response to a petition, the Treasury Department stated that “They could eventually be scheduled for the last month of the current fiscal year, depending on the behavior of the collection of resources that are part of the General Budget of the Nation.”.
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Regarding the validity of 2023, The Observatory states that almost all of the resources were transferredsince the payment is $3.74 billion and the total allocation of the maximum budget for that year is $3.9 billion.
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