12:01 am
The agreements reached by the governmental parties with the Minister of Health and the President of the Republic will not be sufficient to guarantee health care to Colombians.
At least this is the point of view of the former minister of that portfolio in the previous four-year period, Fernando Ruiz, who – due to the debate on health reform – appeared for the first time on virtual platforms with his Tik Tok channel, where he devoted himself to doing pedagogy on the health system. Although he is a former official in a government hostile to the current one, a thirty-year career in the sector gives him the authority to speak for the most sensitive reform of the entire population.
In this sense, he spoke in his latest video about the proposal of the Liberal and Conservative parties and the La U party, whose directors agreed on 20 points regarding the project with the government to move forward, despite the haste and some previous doubts. President César Gaviria.
In addition, in an interview with EL COLOMBIANO, Ruiz warned of two alerts regarding the modifications made by these parties to the original text, which, he said, must be resolved in Congress.
The role of the health insurance system
Although the former official admitted that, after the agreement, “there are some important improvements” such as freedom of choice, the inclusion of the concept of social security and clarity about primary services and primary health care, “the core lies in the role of the insurance company, which must be able to manage risk and effective financing.
In this sense, he explained, the current model has three resource funds managed by healthcare providers (EPS): a resource fund for health spending, another for reserves, and one for administrative expenses.
These funds operate in a chain: that is, if the money for spending on health is insufficient, the insurance company requests permission from the national government to be able to use the reserves, and if the money is still not enough, the balance of funds is available.Administrative expenses. “They must do this because EPS is jointly and comprehensively responsible for the care of Colombians with a contract,” Ruiz said in his TikTok video. If it is not enough after obtaining these resources, the insurance company must respond with its own assets.
This map in the proposal of the parties, according to Ruiz, changes, though not to the same extent in the Carolina Corcho project. In the proposal proposed by La U, Liberals and Conservatives, it changes from where the resource officer tells EPS (or EGVIS, Health and Life Management Corporation) “I give you 5% to management and you only respond to where the money goes (from the health spending fund)”.
In light of this, the former Minister of Health predicts that the government may not have enough money, “the official washes his hands and the Colombians wait for them to provide us with health services or pay for private insurance to meet our needs.”
In line with this, Ruiz told this newspaper that the role of the insurance company is the main thing to solve so that it “doesn’t end up becoming a Frankenstein if the government doesn’t give in.” He added that the 20-point reform included by the parties “is less problematic than the original, but it does not solve the problem of what to do when the gene caring budget runs out and how to adjust the model in which insurers have the possibility of establishing your network, entering into contracts and paying issues.”
The effectiveness of the preventive model in health
Changing the focus in the health system, which is based on treating and curing disease rather than preventing it, is the banner of government reform and was one of the red lines that President Petro and Minister Kuro supported in the five weeks of debates and public hearings after they were raised in Congress.
Faced with this, in dialogues and negotiations with Delian Francisca Toro (from La U), Efraín Cepeda (from the Conservatives) and César Gaviria (from the Liberals), this was not a point of contention, since she is one of those. Commonalities not only in these communities but also among health systems scientists.
To carry it out, among other measures, the government proposed brigades and medical teams in remote areas of the country (“Deep Colombia”, says Corcho) to go to people’s homes to assess their physical condition and in order to detect in time the possibility of diseases that can be treated in time before to evolve.
However, Ruiz maintains data calling into question that prevention is synonymous with disease treatment. There are several of them in a study by Canadian experts Marc Lalonde, former health minister, and Alain Dever, epidemiologist, who noted that health services contribute 11% to a person’s health status. Other aspects such as environment (19%) and lifestyle (43%) are more decisive.
In the meantime, given the possible white smoke of political negotiations, Congress will have to weigh between proposals that make a career and what are the alternatives to address the points that generate fear, among which are the contributions of former Minister Ruiz.
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