Discussions in health continue to worry the sector, as defunding is becoming increasingly evident. A report published by Afidro and Anif estimates that this region, which is characterized as being vital for Colombians, will begin 2025 with a financial deficit of $19.7 billion.
(See: Andi reflects her concern about the technical health tables)
Among the challenges that stand out is that the insufficiency of the financial resources of the health system will continue to affect the treatment process, access to medications and, in general, the guarantee of the fundamental right to health.
Taking this into account, it was emphasized that the greatest achievements of the system have been the coverage of 99% of the population, which is equitable, In addition, Colombia is consolidated as one of the OECD countries with the lowest out-of-pocket spending.
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However, some challenges still remain, such as improving the conditions of human talent in health, infrastructure, and most importantly, financing. In fact, The entities show that the system is already feeling the consequences of definancing.
An example of this is the shortage of medicines, which until September of this year of the 207 medicines listed around nine are at risk and 13 are short of supplies. Regarding another point, the vice president of Anif, Luz Magdalena Salas, highlighted that an increase has been observed in the waiting time for medical appointments and procedures.
“Since 2017, we had observed progress in the waiting time for scheduling appointments and procedures, which was redirected for almost all specialties. However, from 2022 to 2023 some specialties have become more serious, as in the case of obstetrics.”, he indicated.
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Now, one of the bases so that health definancing does not continue to intensify is the calculation of the Capitation Payment Unit (UPC). Regarding this, Anif estimated that an increase of 16.4% would be needed by 2025 alone.which would imply a total budget need of more than $100 billion.
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According to what they explain, the estimates suggest that Since 2021, the UPC calculation is underestimated, on average, by about 2.8 percentage points (pp). Even if the figures are analyzed, it can be seen that in 2021 a growth of this indicator of 7.7% was needed, but the nominal increase was 5.2%, that is, a gap of 2.5 pp.
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Likewise, the gap for 2022 was 2.4 pp, for 2023 it was 2.6 pp, but if we look at the case of 2024, it was projected that the system needed an increase of 15.6% in the value of the UPC, but the decreed was 12%, which causes the widest gap in recent years with 3.6 pp.
“This value is essential to cover next year’s health care delivery needs and does not address the accumulated deficit from previous years. Therefore, it is essential to continue discussing mechanisms within the budget to meet the needs of the system and ensure timely payment of previous debts.”they suggest in the report.
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However, Salas also added that The definancing of the UPC is putting the system in trouble, because not only are debts accumulating over time, but they are also growing more and more.
The vice president of Anif, Luz Magdalena Salas.
Sergio Acero – Portfolio
On the other hand, the estimates of the maximum budgets stood out. In that sense, the entities reflected that The disproportionate growth of spending allocated to maximum budgets is financed from the General Budget of the Nation, so that is where the importance of its correct assignment lies.
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Thus, it was projected that in the last three years, these resources destined for services not covered by the PBS and new technologies, have been lacking and have been underfunded. For example, the report states that for 2022 there was an approximate shortfall of $1.3 trillion, while for 2023 it was $1.4 trillion. By 2024 it was estimated at $1.9 trillion.
According to Catalina Bello, director of Access and Sustainability at Afidro, The lack of financial resources generates a short circuit in the entire drug supply chain, but the most serious impact falls on the quality of life of the patient who does not receive their treatments or medications on time.
(See more: What are health actors asking for to solve the current crisis in the system?)
“From Afidro, we reiterate our complete willingness to collaborate with the National Government and the Ministry of Health in the search for joint solutions, recognizing the debts and current insufficiency, while proposing alternatives to generate more resources and optimize the use of those available.”, he stated.
Health reform.
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Budget need
Taking into account the fiscal deficit estimated by Anif and Afidro in their report of approximately $19.7 trillion for 2025, it was emphasized that this amount It is equivalent to what is necessary to cover the UPC of 15.7 million people who in 2023 They were in a situation of monetary poverty.
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In addition, there is a budgetary need where in 2024 alone the data amounts to $8 billion for UPC and $1.9 billion for maximum budgets. For this, The entities presented some recommendations that focus on making comprehensive evaluations to correctly adjust the UPCtaking into account macroeconomic indicators and the real use of services during the year.
They assure that it is necessary to strengthen information systems and audits, make quality standards in care in dispersed areas more flexible and improve the distribution of human talent in the health sector.
(See: They warn of risk of collapse in recognition of resources for high-cost diseases)
They propose adopting a long-term approach that takes into account the factors that increase spending, such as population aging, labor formalization and technological advancement. and they warn that the most urgent thing is to find new sources of financing.
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