Cancer patients unsure about how healthcare reform will modify treatment of the disease

Systems engineer Carly Dalini’s life hasn’t been the same since 2016, when a suspicion of a mass in her right breast turned into one of the toughest tests: cancer with a high risk of larger tumors in the ganglia and the rest of the body.

“Mine was called triple negative, which has the worst prognosis of all types of breast cancer and is the least common. Prognosis by some doctors was very reserved. Others freaked me out and warned me that chemotherapy wouldn’t help me. Wali and I probably had six months to live”, says this woman from Cucuta.

I will know all this much later. Carle’s priority at that time was professional life. “I was working as a consultant in the Ministry of ICT and I wanted to continue to advance in the job market as I was making contacts and managing projects. Took care of myself in diet, as I had gained weight with pregnancy. When they gave me the diagnosis, it was a difficult moment, as my son was only 3 years old and that successful working life went on the floor” .

It all started for Carly when she felt a painful mass in her breast. And what came next was a long battle with her EPS to get timely care and treatment. He made an appointment first, but later she only had availability for three months. “Seeing the pain, I paid for a private breast ultrasound and I searched in a special way for a doctor who would treat me for EPS. And I also paid one million pesos to have a biopsy and a mammogram on the same day did.

Against all odds, the biopsy revealed that the mass was not cancerous, but Carly was convinced that her health was in fact in grave danger, as the pain was so severe she could not sleep, the mass did not stop growing, she was very Thin and a lot of hair fell out. Her privately treating doctor advanced the appointment through EPS so that she could continue to receive services through her health provider.

“Actually, through other tests, they realized the seriousness of my case,” he says.

Today, this cancer patient, who was diagnosed with ovarian cancer in 2021 apart from breast cancer, assures that, although initially it was not easy to get timely treatment given the severity of her condition —he was also forced to implement Decree 1652 of 2022, which exempts people with high-risk diseases from paying moderator fees and co-pays—, his EPS took a large portion of that cost. Covers what is necessary for the disease: chemotherapy, surgery, medicines, accompaniment and access to specialists.

“In the midst of everything, I was lucky, I was on an oncology route and I had treatment, but, yes, I went to the clinic so that they could give me the immediate treatment that my case required and the order didn’t expire,” she She says Engineer. She left her profession and today shares her story of illness as a life coach and spiritual healer.”

The system isn’t perfect, but it works

Some 138,000 Colombians are expected to be diagnosed with cancer in 2022, according to data from the Ministry of Health, a disease that claims 33,100 lives annually in the country. Of these, 16,300 are men, who are particularly affected by stomach, lung, prostate, colorectal cancer and leukemia.

Juan Felipe Combariza is well aware of the magnitude of the disease. He heads the hematology and bone marrow transplant service at Clinica Colombia in Bogotá, and believes that even though the current health system is “not perfect”, it has experienced significant improvements over the past 15 years.

“Today this disease has been thrown into the public conversation. There are more possibilities of access and treatment, so that if detected in time, one can have a good life expectancy, which was some 20 years ago,” says the doctor.

Combariza highlights, like other advances, that cancer patients are exempted from co-pays (via blue cards). In addition, they have a palliative care law that allows them access to programs to ease suffering in the final stages of illness.

In addition, he explains, they are protected by a cancer law, which requires that medical authorizations be issued in one place so that, “in addition to the burden of their illness, procedures and administrative hassles do not suffocate patients.” “

simultaneously, “Unlike other countries in the region, treatments for people with cancer are part of the system’s benefits plan. Even Colombia provides drugs that other countries do not. In Brazil, for example, patients with multiple melanoma have There is no access to an essential drug called daratumumab; in Colombia, yes.

Experts, however, acknowledge that there is currently a shortage of hematologists and oncologists in the Colombian health sector. Although their numbers have increased, there is a need for more specialized care centers to handle the high demand for patients, especially in remote populations. “But the truth is that today, if a Colombian has cancer, they have a system that covers the whole process of their disease and this is a huge advantage,” Kombarija stressed.

What about our treatments?

That’s the question asked by Daniel Cardona, 51, of Boyaca, who has been battling colon cancer for six months and fears what might happen to his treatment in the event of eventual recovery.

Like Carly Dalini, Cardona faced early delays in her EPS care. “I had to make the right to petition first and then legalize it so that they could give me priority appointments. But throughout this time my EPS has responded to radio and chemotherapy. And when they are gone, what will happen to us?, Will I have to go to Dutma City Hall to schedule my medical appointments?” asks this business administrator, the father of two children, one of whom suffers from Down syndrome.

For Combariza, the ideal is that “a reform that calls for a sudden change in the form of the possible elimination of EPS would have already been socialized with all actors in society. It is scary to think that we will return to the model that was in place decades ago before Law 100, and then people will be forced to go to a nearby mercy hospital or pay for private medicine to guarantee healthcare. , “he reflects. Doc.

And he wonders whether “with the new reform the state will be able to guarantee the health of every Colombian” when the sector’s money goes into the hands of regional entities, one of the points that the reform clearly considers . Its content and scope have not been officially disclosed by the national government.

For her part, Carly Dalini fears that if reform is accompanied by “the conditions that we put in place. On the one hand, that we are exempted from the moderating fee, that cancer programs and emotional support programs are maintained, which are very helpful in cases like ours.

He adds that “what a reform should do is reform exactly what’s working badly, like attention spans, for example. Cancer patients have learned a long time in the current health system so that now Let the rules of the game change in a disease in which everything is a priority and every day counts.

Natalia Carvajal, a medical visitor and marketer with cervical cancer, spoke in a similar vein. It appeared with an endocervical tumor that was advanced, and she preferred to pursue all of her medical procedure through a prepaid medication plan, fearing that her EPS would not act quickly.

“Unlike the experience of many Colombians, she had the financial means. I knew everything would be much faster with a prepaid plan, a gynecologist processing all my orders”. dice.

He tells WebMD that, in a matter of two days, “I already had orders and an operating room scheduled. I knew that with EPS, I should first find a general practitioner, then a gynecologist. and wait who knows how long that surgery should be. So, if any improvements are being made, hopefully the system will improve so that health care doesn’t have to pay more for the time being Had to do it.

health ministry speaks

According to the Ministry of Health, the new model will improve patient care.

• “Patients will not be affected by this new model. In contrast, coverage will be expanded, as some 630 municipalities do not have health posts in rural areas. That is, more than 50 percent of the national area.

• “Clinics and hospitals will not stop functioning. These infrastructures are being used and they will work better as they are being paid directly to make the profession of doctors and nurses prestigious.

• “The model would prioritize prevention, in contrast to what is happening with the current model, which was dedicated to treating disease.”