In the midst of political polarization, health reform advances in Congress. It is true that there have been failures in the functioning of the current system, in a large percentage due to poor surveillance and control by the State, such as the diversion of resources towards areas other than health, corruption and the subsequent bankruptcy of EPS that have left unpayable debts to many lending institutions such as clinics and hospitals. It is also true that we have advanced and today we have a system that, despite its imperfections and thanks to multiple reforms to the initial project, has managed to improve service delivery and the health of Colombians in the last 30 years.
This does not mean that it should not be reformed and improved. There are unresolved problems that warrant it, such as the lack of access to services in more distant places, the little importance given by the current system to prevention and promotion and, in general, to public health. Also the little recognition of talent in health: doctors, nurses and health personnel in general are mostly in poor working conditions, something that the current reform presented does not address.
What has been stated so far changes the conception of insurance. The State assumes all the risk, the EPS are finished and they become “managers”, now they will audit the costs and services provided by the IPS (called clinics and hospitals), controls that will be carried out after the provision.
Payment will be direct from the government to the providers through the ADRES. This seems well-intentioned to me and would solve the delays in the transfer of those resources that providers experience and that keeps them at financial risk today.
It is proposed to access the system through the Priority Health Care Centers, CAPS. You will be assigned to the closest one, where you will be initially treated and, if necessary, referred to the second or third level of care, more complex centers. Authorizations are running out, a good point that would end with lines and loss of time for users.
However, there are concerns about the financing of the new system. There is not really an estimate of the cost and sustainability in the long term. The possible overflow in spending induced by the demand for services without any control could put the system and the health of many Colombians at financial risk.
Finally, there is no ideal health system in the world, neither the United Kingdom nor Canada have one; Wait times for scheduled surgeries and specialty appointments in those countries reach months and are issues currently under discussion. We must continue to find the best system, one that responds to economic reality and guarantees the health of all, one that avoids corruption within hospitals. In my opinion, many voices need to be heard and taken into account in the current discussion.
