The Colombian Association of Comprehensive Medicine Companies (Assemi) made known its concerns about the articles accepted in the first debate on health reform. According to the entity, the government project could mean the loss of 100,000 formal jobs in the sector.
Acemi President Paula Acosta said, ‘We are concerned about how the service will be for the users. There could be significant fragmentation in service, which means there will be barriers to access from the simplest to the most complex services”.
They argue this with the approval of articles such as the Fourth, which refers to the definition of the health model, and which, they say, eliminate basic insurance concepts such as benefit planning.
Another aspect that causes concern for the union is that the reform envisions the creation of a public payer (ADDRESS) and providers (CAPS), which will coordinate the health care of the population.
They also comment that the accepted text sets goals that are difficult to achieve. For example, in two years, at least 2,000 primary care centers (CAPs) will have to be built, enabled and operational. Furthermore, they point out that managers born with the new model are devoid of the resources and functions of EPS. The latter is diluted between public payers, regional funds, departmental planning and assessment units, and CAPS.
“With this, it is very likely that the waiting time for specialized drugs and surgeries and comprehensive care of patients with high costs will become longer. It is also foreseeable that resources will be wasted,” the unit said.
They insisted on the creation of a new risk premium which, they affirm, is incompatible with supply funding models such as the one proposed. Finally, they argue that an insurance model is being established in which the resources are not transferred to a third party, but the health risk. “80% of the resources will be transferred to the providers in advance. Users will lose the ability to choose their own insurer. They’ll just choose the spotlight,” he concluded.
In fact, in keeping with the panorama that ASIMI sees with reform, on May 15 the entity joined the “National Pact for a Better Health System”. It is an initiative signed by over 60 key players in the system, who asked the government to withdraw the project. Signatories include a number of user associations, unions, academia, patients, former ministers and social organizations among other actors.
Augusto Galán, former head of the health portfolio and one of the leaders of the initiative, commented that with this “we respectfully request the government to withdraw the bill in accordance with the President’s invitation to reach a consensus.” Fernando Ruiz is one of the former ministers who also believes that the reform should be rolled back. “The majority of technocrats in the sector have raised many objections to the project. The most sensible thing would be to withdraw it,” Ruiz said.
Gaviria Objections to Government Project
For former minister Alejandro Gaviria, the debate process is going badly in form and substance, and consensus is far from over. Gaviria explained that it proposes an open system, without benefit plans, without UPCs and without contracts with healthcare providers. He assured that the reform does not clearly define the role of EPS in aspects such as network coordination and economic benefits. He also assured that it is a fragmented system that will affect primary care. Furthermore, he said that such an arrangement would lead to a financial crisis.