Precautionary measures from the Constitutional Court protect Colombia’s health system

In recent days, the Constitutional Court adopted precautionary measures on the Capitation Payment Unit (UPC), since following ruling T.760 of 2008 It was identified that within the Colombian health system there are deficiencies in the information systems to calculate the UPCvalue with which part of the health of Colombians is paid.

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According to the Court, to date, the sufficiency of the UPC has not been shown nor has it been shown that this premium and the maximum budgets are sufficient to finance the Health Benefits Plan (PBS).

Portafolio consulted experts to analyze the implications of the precautionary measures, especially on the plan to finance basic health equipment in Colombian territory with 5% of the UPC. This situation showed that the measures are protecting the system “so as not to increase the lack of financing in health.”

(Read more: ‘Fulfilling an EPS role within a system with problems is unviable’: EPS Sura)

It is worth remembering that since previous months the actors in the sector, especially the EPS, have warned about the insufficiency of the UPC due to the increase in services, longevity, among other factors. Even, This week the EPS Sura announced a Progressive Clearing Plan, to which they submitted due to the structural problems of the systemamong them, the insufficiency of these resources.

Faced with this, the director of Así Vamos en Salud and former minister of the portfolio, Augusto Galán, explained that the Court’s order has two key points that must be addressed, therefore, With this, signs are being given of the need to adequately finance the health system.

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In a first point, Galán highlights that one of the keys is the operative part, in which the use that was recorded is stopped. in the resolutions of the Ministry of Health to use 5% of the UPC for the deployment of basic equipment.

“The Court ratified rulings dating back to 2010 relating to a claim that was made, at that time, to use those UPC resources for telemedicine in the most remote territories of the country and for the transportation of patients via helicopters. , that these resources could not be used for anything other than the provision of health services under the Health Benefits Plan”he explained.

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He added that by referencing these rulings and while the lawsuits are resolved, the Court is issuing protection to the adequate financing of the PBS and to the integrality of the use of said resources.

In the same sense, the president of the Medical Law Bar Association, Jesús Albrey González, explained to Portafolio that taking 5% from the UPC, to transfer it to the payment of health equipment, It distorts the purpose of those resources intended for health care of the Colombian population.

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“If the government wants to implement the basic health teams, it must do so with resources other than the UPC, which in itself is already seriously questioned regarding its sufficiency to meet the health benefits plan charged to the UPC, and Instead of increasing it, it was intended to remove 5%”, he opined.

Now, another of the key points of this order lies in the poor calculation that has been made for the UPC. According to Galan, This reflected insufficiency has been evident for some timehowever, suggests that the decisions of these government bodies imply that a review is needed.

(See: ‘The health system with the intermediation of public resources is unsustainable’, Petro)

“The National Government over time has not adequately explained the reasons why the UPC of the contributory regime is greater than that of the subsidized regime., when the benefit plans have already been equalized. The Court even says that the Government itself has indicated that the information for the calculation is not the most appropriate and that it has to improve, but it has not finished improving,” he explained.

In fact, the document issued by the high court highlights that the Government had “committed” to equalize the premiums by 95% and by not doing so, The Ministry of Health was ordered to adopt the necessary measures and issue the regulations that it considered pertinent to solve the deficiencies of the information system.

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Among the solutions detailed by experts so that the health system begins to improve its financial deterioration It is explained that it is necessary for the Government to propose financing measures for basic equipment with resources different from those of the UPC.

(Read also: EPS Sura requests voluntary liquidation before Supersalud: these are its reasons)

According to González, as long as a resource allocation outside the UPC is not defined for these plans “The equipment will not be able to come into operation, since it is necessary to hire it in advance.have the budgetary availability that supports their hiring, whether at the territorial or national level,” he said.

In turn, Galán pointed out that The health system has to be well funded and sustainabletaking into account that there are clear definitions on the focus of execution of the resources of the Capitation Payment Unit related to the Benefits Plan.

(See: Colombia would have to invest more in health, without the need for a reform: how to do it)

“Other types of actions are needed, such as basic health equipment, the strengthening of primary care in the territories, the financing of the improvement of working conditions and the adequate distribution of human talent in health in the territory”, he concluded.