The congressman and strong critic of the health reform, Andrés Forero, warns that half of the project has been voted on “blindly” and that health will end up “politicized.” In an interview with LA NACIÓN, he says that the EPS are going to end them and that part of their functions will be given to mayors and governors. The politician asks the people of Huila not to vote for the candidates of the Historical Pact this October 29.
Jesus Antonio Rojas Serrano
Andrés Forero, member of the Seventh Commission of the House of Representatives, has become one of the most critical voices of the health reform promoted by Gustavo Petro’s government. For this Bogotá politician, the initiative has not undergone major modifications in the Congress of the Republic and is heading to cause a major, unprecedented health crisis in the country.
The Uribista congressman takes advantage of this talk with LA NACIÓN to address the people of Huila and ask them not to vote on October 29 for the candidates of the Historical Pact, since he is the promoter of this health reform.
How is the health reform process going?
The House of Representatives has voted blindly on half of the health reform. Half of the articles have been put up for consideration by the plenary without a concept of fiscal endorsement by the Ministry of Finance and Public Credit, that is, it is not known for sure how much the reform costs us. In my opinion, those who are voting in favor of the project are committing great irresponsibility.
What do you still think about this project?
Jesús Antonio, we feel that, after the procedure in the Seventh Commission and the procedure in the accidental commission, the reform has only undergone cosmetic changes and the concerns that we have expressed are still fully valid. We are very concerned that they are going to politicize health. It is true that there is an article, number 49, that foresees that the EPS are going to become health and life managers, but the truth is that, reviewing the tools and instruments that they are given, one realizes that they are not really going to to be able to fulfill their functions, which, in addition, are replicated in other entities such as Adres, mayors’ offices and governorates. We feel that in practice, beyond what the paper says, they do plan to end the EPS and intend for them to be replaced by mayors and governors in many of their functions.
What else worries you?
The times proposed by the reform for the transition exercise are insufficient; We consider that in two years it is impossible for the mayors, governorates, the Ministry of Health, the Adres and the Primary Health Care Centers to be able to build administrative and technical capacities and assume what the EPS have done for 30 years. It seems absurd to us that the gateway to the health system is going to be Primary Care Centers. I think there are too many instances being generated and the poor patient is going to have a lot of problems when trying to climb the levels of care. There are going to be coordination problems. It is not clear who is going to do the hiring. What is proposed is an agreement of wills, resources will be exhausted early and a large door will be opened for corruption.
So, don’t you believe the Minister of Health, Guillermo Alfonso Jaramillo, when he says that the EPS are not going to end and that they will only have a change in their names?
It’s not just a change in their names. The minister has two speeches, one is the one he makes public to calm people’s concerns, and another is the one he gives in more technical spaces where he says what we are saying: the EPS are not going to contract the care networks. in the municipalities and departments, they will not be in charge of organizing them; The only thing they will do is audit the invoices and it is not clear how they are going to do it. One realizes that what they want to do is completely wither them so that the State can replace them. What I feel is that in practice they are trying to put an end to them. Direct turnaround is one thing, but the government goes much further. The Vice Minister of Health has been very clear that they intend for the mayors and governorates to define the care networks and with that, they are throwing the EPS out of the health system, since they would not have the insurance role that they have today. .
Is the concern alive, then, that mayors and governors will become all-powerful men managing health?
Jesús Antonio, the national government and the health reform speakers are overlooking the risk of state corruption. We have seen how they have stolen money from health in the different public hospitals in the country, how they have stolen money from feeding children. The government is foreseeing that the EPS will not define who is going to be hired in a given network, but rather the mayors and governors. We all know that a huge door is opening for corruption, when leaders have the discretionary power to define who enters and who does not enter a health care network.
Can you imagine these Primary Health Care Centers operating in regions like Huila?
I can’t even imagine them in Bogotá, not because of the lack of vocation of the doctors and health personnel, but I can’t imagine them assuming more functions, for example, managing the payment of maternity and paternity leave or doing the characterization of the population. With great difficulty and with great heroism, doctors and health personnel are providing care to patients and, now, the national government wants to assign them more responsibilities. I remember that in a public hearing, the Secretary of Health of the department of Atlántico asked that they please not be given more functions because they were barely able to fulfill the current ones. So, without thinking about corruption and other issues, but thinking only about the capacity one has, the mayors and governors cannot do it with the secretariats, much less will the public officials who today are heroically caring for patients in very precarious circumstances in some cases.
Have you been able to find the underlying reason for what Gustavo Petro’s government wants with this health reform?
The government improvises a lot. We saw it, for example, with the Soat theme; We warned him from Congress, the academy and the control entities that what he was doing was absurd and irresponsible and time ended up proving us right. They opened a gap of $850,000 million for next year, as Minister Jaramillo himself has recognized. What they did with Soat left a huge hole in the accounting of many clinics. I say all this to explain not only the irresponsibility but how the government sometimes thinks with desire. And in this case, what moves the government is ideological dogmatism; The government assumes that everything the State does will be more transparent and will have better results. We disagree with the simplicity with which the government takes on an issue as complex as the health system. The government has deceived the Colombian people by saying that the next day after the health reform is approved, there will be care in homes with traveling doctors, who will magically disappear the problems of scheduling medical appointments and with specialists; The truth is that that is not going to happen. We feel that due to this ideological dogmatism that believes that everything public is better than private, Colombia is going to end up in a health crisis unprecedented in recent history.
A congresswoman from the Historical Pact came out saying that the health reform project does not require any financial provision from the State. Were you surprised by such a position?
It seems very serious to us. To vote on much less sensitive projects, we are required to have fiscal viability. And in this case, which is a reform that is putting the health of 50 million Colombians at stake, it seems irresponsible to me that the speakers are saying that the government does not need to be clear about how much the project is going to cost. For now, I tell you that an article that was approved this week provides that part of what is being paid today with Soat will be assumed by the entire system, that is, it will not be zero cost. I insist: they are playing with the health of Colombians with a poorly done reform, without legitimacy and that does not have the support of the same doctors, users and academics.
With what is happening in Congress, do you think Petro’s health reform will end up being approved?
I very much regret that the Liberal Party, which in my opinion is the main architect of the current health system, is today giving the national government a majority to demolish that system and take a leap into the void. Between now and the elections, there is no longer room to finish debating the second half of the reform articles. Due to timing, next week we have to discuss the general budget of the Nation for the year 2024, that is, there is no space in the legislative agenda for the following days. It is clear, sadly, that the Liberal Party is destroying its historical legacy to make room for a more nationalized and improvised health system. What I feel is that the reform is going to end up being approved after the elections, but I hope that after the bad electoral exercise that the Historical Pact is going to have, President Petro’s party, the Congress of Colombia will understand the message and show dignity by voting against what remains to be approved of this project. Jesús Antonio, perhaps, I am thinking with desire.
Through LA NACIÓN, what message are you sending to the people of Huila at this time?
I tell the people of Huila to be very careful when voting in these elections on October 29 because with this reform project they are putting everyone’s health at risk. All of us, eventually, are going to be patients or a family member is going to be a patient and, sadly, this government, due to ideological biases, is playing with our health system; Instead of perfecting it, it is demolishing it and taking a leap into the void. In Bogotá, when he was mayor, Petro caused a huge garbage problem; The advantage he had was that after the disaster he caused, he was able to bring back the private operators; That’s not going to happen here in health. And he is going to end up paying with dead people. The crisis will be unprecedented. I invite the people of Huila to take all this into account when voting. It is irresponsible if they vote for the candidates of the Historical Pact, which is the promoter of this terrible health reform.
