In the framework of the discussion on the health reformone of the projects recently filed by the Government and that has generated questions in different sectors, the National Association of Businessmen of Colombia (Andi)presented an analysis of coincidences, concerns and proposals on the initiative that should begin to be processed in the coming days in the Congress.
With the reform, according to the Minister of Health, Carolina Corcho, it is intended to “improve the system and optimize its resources”.
(More: Andi warns about increased costs due to health reform).
Bruce MacMasterthe president of Andi, mentioned that the transition to a new system is one of the points that worries the union the most, because in this process there can be failures in the service to patients, whom he described as “the center of the health system”.
Facing this point, The union reiterates one of the criticisms that they have been making since before the articles of the reform were knownand is the possibility that “the right to free choice that has been the foundation of the current system is lost. It is not clear if the Comprehensive Resolutive Primary Health Care Centers (Capris) represent the user, if they manage their health risk and also the financial one, if the territorial entities make up the networks and how care is guaranteed outside the Capris for the citizen in mobility”.
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Therefore, they consider that with this reform “the health budget can overflow and lose its containment mechanisms, affecting public finances”and, at this point, they make special emphasis that it is not clear how the financing of primary care will be, one of the key points in the Government’s initiative.
In the socialization that the minister advanced in the Seventh Commission of the Chamber, she explained the cost of operations of this care model in what they have called “the deep Colombia”, which represents 17.3 million people and, according to Carolina Corcho, it would cost $8.7 billion, which would come from “the more than $80 trillion that the system has”.
“The single tariff for the provision of services can discourage the offer of quality services for patients and investment in technology and innovation in health”, sentence Andi, arguing that “There is no clarity about the criteria for the formation of networks and the participation of private providers, only reference is made to the priority that the public provider will have”.
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The role of Administrator of the Resources of the General System of Social Security in Health (Adres)which is now in charge of managing the money that supports the provision of health services, is another of the red lines, because in the articles of the project that the Executive presented this entity would assume many of the functions of the EPS and Andi believes that “it does not have the operational capacity to be the sole payer of the health system, which can lead to a collapse and consequent failures in health care”.
Another question is thatthe proposed governance structure creates bureaucracy, increases the risk of political interference and probable corruption in the health budgets in the territories”.
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On this point, the Minister had reiterated that “the health system will not be managed by rulers and mayors”.
Among the concerns, this association also raised issues such as that “the reform project does not have an orderly transition for the EPS with risk to users”, a position that they support under the premise that “the current insurers acquire a limited role in the field of primary care and with purely operational functions”.
They also add that “the proposal may have an unsustainable fiscal impact and that the new model may lead to an increase in the cost of prepaid medicines and, in general, to an increase in private health spending for Colombians”.
From the National Association of Entrepreneurs of Colombia (Andi), they propose: “make the patient and families the center of the system”as well as “implement compliance with the agreements between EPS and providers, strengthen the direct line of business from ADRES, a mechanism that has operated successfully for the subsidized regime and to a lesser extent in the contributory regime, and articulate the different health actors in the territory through a policy development of public healthlyca”.
CLAUDIA M. QUINTERO RUEDA