With the changes in EPS, three coalition parties proposed new materials

The health reform government of Gustavo Petro is risking his life this week. César Gaviria, President of the Liberal, Efraín Cepeda, President of the Conservative Party, and Dilian Francisca Toro, Director of La U, finished Monday evening preparing a document that they will present to the Executive for consideration.

The truth is of no small importance, because if the government does not accept in-depth discussion of the proposals that these parties consider necessary – defined in what they called the “red and blue lines” – The next scenario of a formal alliance could be critical: liberals, conservatives and “la yo” are ready to present their counter-reforms, as the Democratic Center and Radical Change have already done.

(Also: Health Reform: Proposing Liberals, Conservatives, and the “U” of Government)

And that they present their project is not the main problem of the government. Petro’s problem is that if these forces leave a new article, the head of the ruling party will see the support of 75 deputies in the Chamber and 38 senators in jeopardy.

this means The government will be left alone with the votes of the historic charter, Perhaps the Green Alliance – which has not yet determined its position – will not be sufficient to implement the initiative.

It can be said that these parties have the executive between a rock and a hard place, which will have to negotiate and give in to their demands. And the sectors of the hardline current of Petrism, starting with the Minister of Health, Carolina Curco, will find themselves in a paradoxical scenario: on the one hand they saw the winners of the departure of the most critical of the reform minister, Alejandro Gaviria. But on the other hand, they will not be able to impose their radical proposal to change the health paradigm.

(You may be interested in: Petro: the reform that caused a ministerial crisis and put the coalition in suspense)

Calm discussion is not expected, because the three communities agree that EPS cannot disappear, and they warn that this is what will happen with the project that Corcho is leading, reducing his role in the system to the extent that several sectors warn about it. Almost complete nationalization of health in Colombia. This is the fundamental aspect that separates liberals, conservatives, and no-yo’s from the official project.

EL TIEMPO learned of a document of 40 articles that underwent the most recent revisions last night. The focus of the text, which will be handed over to the President once passed by the benches, keeps the EPS alive, which the Parties now propose to call “Health and Life Management Entities” and which can be of a formal, private or mixed nature, as is currently the case.

But, unlike the government project, which reduces the current jobs of EPS, That the three parties maintain a function of “smart management of health risks for the people and communities in which they work and of their choice”.

In other words, EPS – now ‘Health and Life Managers’ – will continue to hold affiliates, albeit prioritizing, as the government proposes for the whole system, care that is “responsive at a basic or basic level, close, focused on the user and where they live.” And works in it, beyond market considerations. In this primary care, the Primary Care Centers (CAPs) proposed by the government will play an essential role.

(Keep reading: Liberal party will apply seat law to vote on health reform)

However, there’s a key difference with Corcho’s proposal: People won’t have to register and agree to receive care in a government-provided setting, but users. “They will have the right to freely choose the health and life management entity they prefer, within the offer available in the respective region.”

Also, as today, “the user will be able to navigate at any time.” In addition, you will be able to “select the attending physician of your choice” within the network.

Another major change, along the lines of what the government is proposing, It is to abolish subsidized and shareholding systems and create a single health system that is highly focused on user care.

(You may be interested in: “Since the text of health reform is today, we will say no”)

In terms of resource management, these parties point out that Adres delivers directly to IPS and pharmaceutical companies and that the Entities of Health and Life Management (EGVIS) are responsible for auditing. But once again they depart from the official proposal by denying that regional authorities can have almost complete control over health in their areas. They don’t want to “bureaucratize” or increase the risk of corruption so they eliminate these regional figures.

now, The ball will remain in Petro and Korcho’s court, that they would have to analyze the new materials and decide whether or not to approve them so that Congress could fully participate in the discussion.

This debate is going on in the middle A political storm lives in Nariño’s housebecause in less than a week there was a cabinet reshuffle that led to the departure of Gaviria, in addition to this, several high-ranking officials – among them the Minister of the Interior, Alfonso Prada – were sprayed due to the leak of Nicolás Petro talking with his ex-wife, Daisoris del Carmen Vazquez, where they talk about alleged bureaucratic quotas.

This situation has nothing to do with health reform, as some sectors are already talking about a primary governance crisis that the parties can exploit when imposing conditions on them. Certainly the pressure policy will come from both sides. Let’s see how it turns out, but the cliché answer is always the same: let’s hope the country debate is above all these accounts. “But there will be a governance crisis and there will be more pressure, no doubt,” said Ariel Avila, a senator for Alianza Verde, who is close to the executive.

(In other news: Roy broke his silence and came out in support of Petro after Nicholas’ controversy)

Added to that, Prada took a beating. Several sectors exclude, for the time being, the suggestion of censure, because they agree that it is necessary for investigations to progress to determine what the “ten stakes” that Petro’s eldest son is talking about are. Cambio Radical congressmen, such as Carlos Fernando Motoa, agree that this issue will delegitimize the reforms and the ministers mentioned in the chats.

Prada is one of the most respected government officials and has shown impressive political management, as his role was instrumental to the official in Congress approving last year’s reforms, including tax reform.

And now, her role remains key, especially given that there has been so much resistance in the Capitol against Secretary Corshaw, which Ruy Barreras himself, president of Congress and Petro ally, has described as an “ideologist” and someone who “doesn’t listen.”

With Prada affected by the Nicolás scandal, it is likely that the government will reach Congress with less spirit to enforce the most important points of reforming the corcho. For now, Senator Barreras has returned after a few days of public isolation to come out in defense of the president and declare that health reform, with changes, will move forward.

Matthew Garcia

Political writing