Tuesday, November 5, 2024

The new role of EPS

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Last Friday, at the end of the afternoon and when there were very few people in camera actorYesthe Power point For the first discussion in health reform, one of the most criticized. but, What’s new in the 527-page document that was left with the signatures of the Conservatives and “La U,” though not with the approval of La U’s director Delian Francisca Toro and, as it was known, without the approval of the Liberals?

the EPS Continue as in the initiative suggested before Carolina Corcho, Minister of HealthHowever, they accept a name Health and life management entities. The parties have criticized regional funds and are considering direct transfers of resources, as well as banning vertical integration.

(“The health reform project includes ideas from the parties and society”).

The show brings together elements common to the backlog of projects, such as:The need to enhance primary health care, public hospitals and the dignity of health workers and improve the flow of resources through the use of direct address transfer mechanism.“.

So, “The focus of social health insurance is maintained as a guarantee of comprehensive universal health care.” In addition, it was emphasized that the State will influence the determinants of health “in order to improve the general and individual living conditions of the inhabitants of the national territory.”“.

As for EPS, which is the cornerstone, it must be said that they have been performing functions such as guaranteeing, which according to Fedesarrollo is what allowed today to cover 93%; Mediation of state resources, health risk managementamong others.

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(Health repair sheet keys saved).

In the project, many of these functions have been removed from it, leaving only audits, management of primary care centers and a few other functions. They take on the role of insurers and health risk managers. In the offer document it reads that EPS is “Compliance with the applicable qualification and continuity criteria of the regulations, and those who wish to continue participating in the social health insurance system, will become health and life management entities in the next two years. To do this, they must file an Acknowledgment of Debt and Payment Plan in relation to health service provider entities.“.

After 2 years, EPS, which will be called Entity management“,”It may be of a private or mixed natureAnd they will have to perform certain functions that are far from the ones they are doing now. It is detailed that in this transition process, “They will receive the annual value per person without putting money, for services of medium and high complexity, which will be recognized monthly according to the definitions of the Ministry of Health“.

(If the health reform goes down, there will be a positive economic effect.)

reads that “The National Health Supervisory Authority will, through an Administrative Act, authorize the operation of health promotion entities which, by becoming health and life managers, are concerned with the management and employment of medium and high-complex services for the population to which they are authorized and the performance of other functions that correspond to them“.

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This means that the role of the insurance companies requested by the parties is transferred to Al-Idris. according to Danish quality of life questionnairethis role allowed for The health insurance rate is 93% by 2021 and the Ministry of Health is revising it at 99% in 2021.

(Former Minister Ruiz highlights the health system’s learning curve.)

According to him Former Health Minister Fernando Ruiz“,”In practice, individual insurance is disappearing. The address has functions only on resources. Individual health risks end up being borne by the person themselves as well as the associated financial risks“.

Presentation directly from Titlevertical integration is not allowed and what both sides are proposing in it now managers They will only receive up to 5% of UPC resources for administrative expenses (a value that will be estimated in the regulations). They will not receive a UPC resource for health or payment of financial benefits. These resources will be located in Adres and will be sent directly to health service providers and health technology providers.“.

(“No new health reform bill was needed”).

The point made from the parties articles is “The debts left by the liquidated EPS in public hospitals will be paid gradually, on future terms agreed with the Ministry of Finance“.

In the presentation, regional funds will be created, but as part of The only public health fund It is added that “There will be a manager from Adres who will order expenditures against the resources of that regional fund. Likewise, it is obviously a fund of account. In this way, the observations of the Liberal Party, the U Party and the Conservative Party are collected, specifying that these funds are not entities, but merely an account“.

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Discussion pending articles in the Seventh Committee and plenary sessions, where there will be changes.

Claudia M. Quintero Rueda
Journalists portfolio

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