Since the articles of the health reform presented by the Government became known, one of the key points is the role that the New EPS would play, an entity with private and public capital, in which the State has 49% of the shares, according to the Minister of Health and Social Protection, Carolina Corcho.
(Read: The most controversial points about the figure of the New EPS).
According to some health experts, this has risks because of the difficulties that serving more users in the system would bring in the middle of the transition and by vulnerability with political expediency.
The Nueva EPS began operations in 2008, from the transfer of the users of the Social Security Institute (ISS). It now has coverage in 1,117 municipalities in the country, according to the figures provided by the entity.
Additionally, until December 2022 reported 4.53 million active users in the contributory regime, while in the subsidized regime it had 5.29 million, which makes it one of the largest health promoting entities in the country.
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His leading role would take place in the reception of users that come from liquidated EPS and in the contracting of Comprehensive Resolutive Primary Care Centers in Health (Capirs), another of the focuses that the Executive intends to do with this initiative.
In article 149 of the reform, which details the transition regime and evolution towards the new health system model, these functions are specified.
“In the territories where there are no Health Promoting Entities, the New EPS will preferably assume the insurance or, failing that, those Health Promoting Entities with the capacity to assume the operation in these territories will do so.”.
“For the territorial reorganization of affiliates during the transition, the New EPS or the existing EPS may assume the affiliates of Health Promotion Entities liquidated or incapable of serving their affiliates,” it adds.
(Keep reading: Andi warns about increased costs due to health reform).
And he points out that:The New EPS will hire the Comprehensive Resolutive Primary Health Care Centers (Capirs), if necessary, or assign the population affiliated to it in such Centers that are operating under the rules of the new Health System, in the prioritized subregions or municipalities. in its implementation”.
And in article 151, one of the ones that has received the most questions for being the one that grants the President extraordinary powersit is mentioned that the Colombian Head of State may “issue the provisions and carry out the budgetary operations required to capitalize the New EPS in the transition period, as well as issue the corresponding organic provisions for its proper operation.”
Paul Rodríguez, an expert health economist at the Universidad del Rosario, mentions that this leading role of the New EPS reflects “is that the Government does not intend to design a specialized transition plan”, because a large part of the responsibility that should be the Ministry will be transferred to an entity that is not public.
In turn, it is true that the results figures for this entity show that it “has matured”, as health consultant Cristián Vanegas adds, but doubling the size with a system in transition and with little clarity in terms of timing and exact functions, “could be dangerous, especially when requesting loans from the financial sector,” adds Rodríguez.
(In addition: Who would manage health resources if the reform is approved).
The economist adds that the precise role of a state monopolization with these new functions is not clear, but “the objective in the reform is to leave the system completely monopolized within the State”, as he adds.
On the other hand, Vanegas says that “there is a risk because the New EPS is going to be a dominant player and that implies that it will be able to better negotiate prices with providers.”
could disappear from the market
Augusto Galán Sarmiento, former Minister of Health in the government of Ernesto Samper, considers that it is possible that “the New EPS becomes completely state-owned, which would be a resurgent Social Security”.
Due to the foregoing, it adds that this entity “disappeared in a not very long term”, this if the reform passes without modifications regarding the functions of the New EPS and Health Promotion Entities in general.
Galán agrees with the economist Paul Rodríguez, in the sense that the reform aims to achieve a state monopolization of health.
The above is evident, according to the consultant Cristián Vanegas, in that with a greater number of users, the providers will have to adapt to the conditions”.
CLAUDIA M. QUINTERO RUEDA