Health reform: accounts that Andi makes about the impacts that the project would have

The situation of the health system continues to worry most of the sectors that comprise it, but also businessmen, who warned that the Government’s health reform is fiscally unviable. for the billion-dollar impact that its implementation would have.

(Read: Andi’s warning: health reform would generate a deficit of $163 billion)

The National Association of Businessmen (Andi), revealed that in the health reform, according to the union’s calculations, there will be a deficit of $141.4 billion in the next 10 years, while the estimates of the Ministry of Finance show a surplus of $21.8 billion. That is, a difference of $163 billion.

Specifically, the business union highlighted that the fiscal projections of the Ministry of Finance underestimate the expenses associated with the bill, which has already passed its first debate in the House of Representatives, and that this would bring “serious” consequences to the Colombian health system.

(Read more: These are the articles that were added to the health reform that was approved)

Based on the results delivered by the entity, on the estimates on the general balance of the system’s finances, in the scenario where the articles had already been approved, to next year there would be a deficit of at least $9.2 trillionin relation to the total expenditure that is projected at $112.1 billion, compared to total income that would be $102.9 billion, in 2025 alone.

Likewise, if the figures for subsequent years are analyzed, at least until 2034 annually the system would lack resources to meet its health obligations. For example, By 2026, $13.1 billion would be needed, but by 2027 the figure would decrease to $9.5 billion.

However, from 2029 to 2034, the deficit would increase year by year, until reaching the latter with a debt of at least $19.9 million (See graph). In that sense, if the amount of the 10 years is analyzed, on average about $14.1 billion would be required, which translate into more resources than the Government is seeking today in the current Financing Law, which is for $13 billion..

(See: Health reform: the project was approved in the first debate in the House)

These data led the president of Andi, Bruce Mac Master, to assure that Colombia would not have the fiscal capacity to carry out the current health reform. Furthermore, in some of the items of the fiscal concept delivered by the Treasury portfolio and in the presentation of the first debate of the bill, There are destinations that do not have a realistic expenditure estimate or simply do not correspond to the proposed text.

(See also: ‘An inclusive environment must be built in which voices are heard’: Novartis)

Some of them are information systems, current obligations of maximum budgets of 2024 with differential Soat, the liabilities of the New EPS and the proposal for human talent in health.

Now, with this context, Andi estimates that the growth in health spending can be decomposed into two elements, the increase and aging of the population and the projection of the Capitation Payment Unit (UPC) of medium and high complexity.

(Read more: The tensions that the health reform has generated, according to the Ascif union)

According to calculations by the Ministry of Health, a real annual growth of medium and high complexity UPC is projected of just 1.5%. But in the last decade, The UPC has increased on average 3.7% in real terms and in the last 5 years 4%.

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“Our calculation incorporates the population projections estimated by Dane, as well as an average growth of the UPC of 3.7% in real terms. The difference between the probable medium and high complexity path and that estimated by the Ministry of Health amounts to $129.6 billion in the next decade“Andi assured.

(See more: Health reform: this was the debate this Wednesday in the Chamber)

According to Mac Master, this accumulated deficit year after year is going to generate a crisis in all the entities that are part of the health system and “lWhat we are going to have is a large number of institutions going into insolvency. We are putting operational, medical and scientific sustainability at risk”, he noted.

He added that it is necessary for the congressmen who are currently discussing the reform and the actors in the sector to be aware of the “looming crisis” and that they are available to correct the figure that is required, “but what is projected is a situation that no Colombian wants for the country“he indicated.

(Also read: Scientific societies warn of the risks of health reform)

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Expenses add up

Now, other considerations that the union put on the table refer to the fact that in the proposed scenario of the reform, an accident rate of 95% and sufficiency of the Capitation Payment Unit (UPC) are assumed. However, In the real matter of the situation of insufficiency of the health system, it is necessary to adjust the initial values.

(Read: The health sector would start 2025 with a fiscal gap)

Also, they stated that the projections do not include the cost of the construction of the Primary Health Care Centers (Caps), one of the flagships of the project proposed by the Government, and that According to the Feasibility Scenario of the Ministry of Finance only between 2023 and 2024, they would have a cost of $7.7 billion.

“They also do not include the formalization of human health talent in the private sector, which is at least $4.3 billion per year. Neither the payment of contingent liabilities due to insufficient maximum budgets nor UPC“, they point out.

(See more: Andi reflects her concern about the technical health tables)

Finally, they pointed out that although the cost of Primary Health Care seems to be in line with what was observed, there are two aspects worth highlighting that could increase its cost. Firstly, the change in routes and On the other hand, the effect of increased demand for services, which may imply a higher cost in the short term..