The next government will have to face one of the biggest crises that the Colombian health system has gone through in recent years.
This was warned by Ana María Vesga, president of Acemi, an organization that brings together Health Promotion Entities (EPS), who pointed out that the new administration will receive a sector marked by healthcare difficulties, financial problems and a growing loss of trust on the part of users.
As explained by the union leader, the main consequences of this situation fall on millions of Colombians, especially those who depend daily on treatments, medications or medical procedures.
According to figures mentioned by Week Magazineduring the last year more than two million complaints and claims were registered related to delays in medical appointments, delivery of medications and performance of surgeries.
For Acemi, the immediate priority should not be a new structural reform, but rather guaranteeing care for the most vulnerable patients and stabilizing the functioning of the system.
Vesga stated that health has become one of the main concerns of citizens due to the progressive deterioration of care. In this context, he insisted that the next government’s decisions should focus on solving the urgent problems faced by users and ensuring the continuity of treatments.
The president of Acemi also maintained that one of the main mistakes of recent years was turning health into a scenario of political confrontation.
As explained to Week Magazinethe system requires technical decisions supported by scientific evidence and specialized analysis, but much of the recent discussion focused on ideological disputes that ended up displacing priority issues.
Among these urgent issues, he mentioned the financing of the system, the strengthening of primary care, the financial sustainability of institutions, the improvement of territorial capacity and the modernization of insurance mechanisms.
The union believes that the first task of the new government should focus on patients with the highest medical risks. Within this group are people with oncological diseases, chronic pathologies and orphan or rare diseases that require constant monitoring and permanent access to specialized treatments.
To face this situation, Acemi proposed establishing daily monitoring mechanisms that allow verifying the timely delivery of medications and guaranteeing the continuity of treatments. The initiative contemplates the joint participation of insurers, health service providers and territorial entities.
“The life of Colombians does not wait,” said Vesga, according to statements collected by Week Magazineinsisting that thousands of patients require immediate responses and cannot wait for political or administrative discussions to be resolved.
One of the union’s central proposals is to implement a strategy called Tip-Pyramid, which would allow the most critical patients in the country to be identified during the first 90 days of the new government for permanent monitoring through real-time information systems.
The initiative proposes creating a kind of Unified Command Post in health that allows monitoring treatments, availability of medications and continuity in medical care for the most complex cases.
Another of the approaches formulated by Acemi is related to the updating of the Capitation Payment Unit (UPC), a mechanism through which the State recognizes resources to finance the care of affiliates.
The organization considers it necessary to carry out a complete reengineering of this tool so that its calculation incorporates more precise variables regarding the real risk of patients. Currently, factors such as age, sex, municipality of residence and affiliation regime are determining factors in establishing the allocated resources.
However, the union proposes to include additional elements such as the type of disease, the specific risks of each population, the observed accident rate and the real behavior of health inflation.
Likewise, Acemi insisted on the need to advance a financial consolidation process that allows updating the accumulated obligations with clinics, hospitals, suppliers and professionals in the sector.
The proposal contemplates a four-year gradual payment scheme. According to the formula proposed by Vesga, 40% of the obligations would be covered during the first year, 30% during the second, 20% in the third and the remaining 10% at the end of the presidential term.
The union also drew attention to the future of the intervened EPS, which currently provide services to nearly 18 million Colombians.
In that sense, he proposed that entities that demonstrate financial and operational viability can recover their autonomy under strict conditions of authorization, while those that do not meet these requirements be liquidated through orderly processes that avoid impacts on users.
Acemi concluded that the recovery of the health system will require the coordinated participation of patients, doctors, EPS, hospitals, pharmaceutical industry, academia and state entities, with the purpose of building urgent solutions that allow us to regain trust and guarantee the care of millions of Colombians.
