The reform that buried our healthcare system completed its process in the House of Representatives this week. As I warned before, all the delays in the process were deliberate so as not to confront the country in the elections. After the elections the liberals, half the conservatives, half the ‘greens’ and of course the whole of the ‘U’ came together to guarantee the ‘majority’ and voted for the project, yes, the bureaucratic privileges in the turtle operation and the congestion that has been running rampant for the last two weeks.
Alarms and complaints from all actors in the system, including doctors, academics, unions, patients and citizens, remained inconclusive. All red, green and blue lines vanished before the steamroller of the Government, which had lost not only the fear of justice, but also the shame in the face of the society that trusted that the promised Change was, above all, contrary to political traditions.
The reform approved so far in the House is a disaster because it alters the health insurance model that is the largest public-private alliance this country has ever had and that guarantees the advancement of this fundamental right. With the reform, the health system is being nationalized, 20 EPS are replaced by 25,000 Primary Care Centers (Covers), which do not exist today and do not have the necessary technical skills, and all kinds of political and clientelistic interventions will be made.
Free choice is being eliminated by reform. Today we can choose the insurance company and the social assistance network it offers, but with the reform the only option left is to register at the place of residence. From now on, everyone should trust the state, governors, mayors, and every bureaucrat who has the discretion to make appointments.
The installed capacity of the private network may also be lost. In Colombia, private provision of clinics and hospitals is required to guarantee the current 99% coverage, accounting for 90% of the total service to date. Networking by a public entity creates uncertainty for the investor and reduces incentives for quality and better health outcomes.
With the reform, we return to the expenditure-related supply subsidy scheme. This creates an increase in separation from the effective delivery of the service. Right now we don’t even know who will dispense the medications, how the continuity of services will work, or what the patient’s path to access the system is.
The superpowers given to the Address cause great concern. This entity was not created to hire, supervise, pay, do whatever. The elements and tools this beast will have to manage financial risk are also unclear because it is presented as a single payer. Can you imagine what it will be like to operate an account with this entity in the future? So which service providers will be exposed to toll and corruption risks?
As has been said from the beginning, EPS will end when they become the managers of health and life. They will be merely operational entities, with vague and collaborative functions, as they are today in the reform; This poses a threat to patients as there will be no one to represent them and ensure the continuity and comprehensiveness of healthcare services. When EPS is eliminated, supplemental plans and benefit plans disappear. As a result, prepaid drug policies and plans will become exponentially more expensive due to market dynamics.
And new Social Security will come, the epicenter of reform and the capitalization of New EPS with the aim of completely nationalizing the system.
What is approved is the worst of the worst. But there is still hope that this dangerous and unconstitutional reform will be shelved in the Senate.
Note: Dr. Caicedo Ferrer insists nothing is happening in his industry. You are right. There is not a single tender going on, tolls have not been adjusted or compensated, everything is underfunded and demands are growing exponentially. The construction works sector has been the worst performing sector to date; It’s down 15% this year and there’s no sign of it rising next year. But to him everything was divine.
GERMÁN VARGAS LLERAS
(Read all articles by Germán Vargas Lleras on EL TIEMPO here)
Source: Exame
