Health actors continue to look for alternatives to remedy the crisis which has been evident in the sector in the last year, due to the lack of funding of the system, but also due to the uncertainty caused by the discussion of a reform in which the Government failed in its first attempt.
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Now, on this occasion, the group of Fundamental Agreements made up of the 21 medical and health professions organizations signed their reform proposal, “with an independent, academic, technical and scientific spirit,” which they expect to be filed on July 20.
In detail, this text proposed for the project proposes a preventive, predictive and responsive care model where the primary health care strategy is based, focusing specifically on people, families and communities.
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Additionally, it establishes a series of strategies such as health promotion, prevention, diagnosis and treatment of the disease, recovery of health status, rehabilitation, palliative care and support until the end of life, as well as intersectorality and community participation.
In this sense, the model estimates that intersectoral work is done with a first level, which would be made up of Basic Health Teams and First Level Health Care Centers (Caps), which will constitute the first link of contact of the system, to in a second step integrate and coordinate the care process that would be part of the Comprehensive and Integrated Health Services Networks (RIISS).
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The EPS have accumulated a loss of $7.1 billion, to which the deficit for 2024 would be added.
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Although each of the components of health is one of the nuts that makes the efficiency of the system effective, one of them is the cause of the uncertainty regarding the future of the sector in the country. Within this reform proposal, The transformation of Health Promoting Entities (EPS) into managers, with a more active presence, is also proposed.
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The 21 organizations raise the need to comply with certain parameters that refer to these managers, once transformed, participate in the organization of the CAPS, which will be financed by Adres with supply subsidy resources.
They also insist that if the bill is approved, within two years of its implementation, the Ministry of Health will determine, according to the capacities of the Adres, thethe implementation of direct transfer for all these entities.
However, they also say that once the two years of this article have passed, The managers may not have vertical integration at the complementary level of medium and high complexityas well as with specialized centers.
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“The managers who remain for the two years established in this Article will be recognized the annual value per capita without a funding situation for medium and high complexity services, value that will be settled and paid monthly in accordance with the provisions of the Ministry and the National Health Council”, they highlight.
Healthcare system
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Financing of the system
Regarding the management of financial resources in health, one of the most important points in reference to the underfunding crisis that this sector is facing, The bill highlights that the Government will allocate an increasing percentage to the sector annually.l, in real terms, of the General Budget of the Nation. In no case will this percentage be less than the highest value between the CPI caused and the increase in the current legal minimum wage.
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It also states that the Ministry of Finance must define, within a period of no more than six months, once the law is approved, a 10-year financial plan with the necessary resources and respective sources to guarantee the financial viability of the system.
Regarding the Per Capita Payment Unit (UPC), that is, the per capita resources defined for care and services, The value will be determined based on technical and independent studies that define a calculation methodology.
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Health.
Although, it should be noted that both the Health and Treasury portfolios They will have to specify the sources and types of resources according to their destination As for primary care, those funds that are from the system, but that belong to the UPC and those defined to cover the Health Benefits Plan (PBS).
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On the other hand, it is proposed that the debts left by the liquidated EPS to public hospitals be cleared They must be paid gradually over a period not to exceed three years after the Law comes into force.with appropriations from the General Budget of the Nation agreed between the Ministry of Health, the Treasury and the National Planning Department.
“The debts that any of the actors of the Health System have to date with human talent will be classified as first-order credits, regardless of their contractual origin.“, they say.
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Health finance
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Looking at one of the bases of the system, which is PBS, where a large part of the services for citizens are covered and which is an axis of the sustainability of the sector, This project aims to progressively expand this tool through a technical-scientific mechanism. which will have to be approved by the National Health Council.
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They add a section on Complementary Social Services in Health, which are those that the population needs, but due to their socioeconomic or geographic condition they cannot make them effective by themselves. For this reason, This point includes transportation, lodging, care or personal assistant services at home and those that the Ministry of Health intends to add.
Within this reform, the objective is for the Health portfolio to define the resources to finance this program, as well as the population that benefits from the service and coverage. However, They are clear that these services would not be paid for with resources from the Capitation Payment Unit (UPC).
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Health reform
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Another key issue is high-cost, rare or catastrophic diseases. In this regard, it is proposed that the Ministry of Health establish the organization of networks of specialized institutions and centers for the detection, prevention and care of this type of pathology.
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“This is done in order to prevent possible complications, carry out screening, optimize the diagnosis and promote the provision of the best possible care, regardless of the geographic location of the institution or the patient.“, they say.
Finally, they detail that national networks can become centers of excellence and reference, where the health portfolio and Adres, They will guarantee the financing of the provision of services, comprehensive care and access to essential medicines and technologies for these types of diseases.
DIANA K. RODRIGUEZ T.
Briefcase
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