Operational challenges of health reform

At the beginning of the week, the accident committee’s dialogue tables were prepared; The meetings began by discussing the financial situation and logistical aspects of the system. One of the participating actors was ACEMI, the EPS consortium for the contributory system, which raised several critical questions about the sustainability and validity of the proposed health reform.

According to Mario Cruz, Vice President Technical and Studies, the following are the challenges that the government initiative does not respond to or for which the materials do not provide clarity, especially regarding future operations. In total, there are 8 operational and logistical challenges that we share with CONSULTORSALUD readers:

Current financial crisis: In recent years, health promotion agencies have faced clear financial difficulties, which reflects a clear deficit in their accounting records. Cruz stated that this situation is due to multiple factors, including the COVID-19 pandemic, the benefits plan expansion in 2022, and problems with updating the Single Payment Module (UPC). He noted that the accident rate shows that earnings per share are spending more than they are earning, which highlights the system’s budget constraints.

Lack of resources for repair: ACEMI’s Technical Vice President warned that the proposed reform lacks comprehensive funding The Ministry of Health expected a deficit for 2024. He stressed the lack of resources needed to fully implement the reform, which includes the implementation of Primary Health Care Centers (CAPS) and other components of the health system.

“There is no money for CAPS, there is no money for outside teams, they asked for five billion and they did not get a single peso. “We do not have the money from the maximum budgets, that is, the money that funds all non-PBS spending.”Cruz said.

Insufficient time to transition between systems: ACEMI highlights that the two-year period is insufficient to implement the transformation proposed in the reform, particularly with regard to the establishment of 2,500 Primary Health Care Centers (CAPS) and the implementation of a single information system for health.

“One year to build one public information system. It is unattainable. Countries like England, which have tried to build a unified system, have taken more than 10 years and invested tens of billions of pounds to do so. “After a year, it seems very unlikely.”.

EPS Liquidation Process: Mario Cruz highlighted that the process of closing health promotion entities (EPS) is not as simple as it may seem, due to contractual obligations with the service providers and staff involved. This will require an additional investment of time and resources, he said.

“Next, we will have to see whether the incentive system in place will allow us to enter private capital that is, in addition, interested in betting on managers’ numbers.”He finished.

Other items demonstrated by ACEMI

In its remarks on health reform, ACEMI presented other factors that should be reconsidered in the articles:

actor Asimi He emphasized The process of population aging in Colombia is acceleratingThis increases the burden of disease and the demand for medical care, especially among people over 40 years of age. According to Cruz, this has a direct impact on health system costs: “From the age of 40, and even more so after the age of 50, the use of health services increases dramatically, leading to an increase in the burden of diseases on the population.”.

In addition, on behalf of EPS Contribution, Cruz expressed his concern regarding… Eliminate supplementary plans. This would affect about 1.5 million middle-class citizens who have access to high-quality services through these plans.

Finally, health reform would have a negative impact on employability. More than 100,000 people currently work in formal positions in health promotion entities (EPS); Therefore, the disappearance of these entities could have negative repercussions on the employment and job security of this category of workers.