Tuesday, February 7, 2023

Health reform: details of the project that the government will present

it’s about a document that has been preserved with great enthusiasm by Minister Carolina Corcho and his closest group of aides, which has been revealed in some closed circles, hoping to have the text of the project ready once it is filed in Congress.

The principles governing the health reform project are Defense of social security, political-administrative decentralization, “everyone puts in”, control of resources and organization of health services by the state; technological management and transparency in the management of resources and “a health service that guarantees the right to health and eliminates the social fragmentation and great inequality of the existing system.”

all put

All Companies, Employees, Independent and Capital Tenants They must contribute to the parafiscal fund without exception; Companies in proportion to contracts made for private work or services and to workers, the self-employed and renters in proportion to their income.

Every work contract or payment, regardless of legal form, must include contributions to social security, if not made, Will generate an enforceable debt with Social Security And it will become a liability with tremendous recovery.

The state may temporarily subsidize contribution obligations for the health of micro-enterprises and the self-employed, When your estimated income is below the economic poverty line of an average family.

in no case, Non-payment or delay of social security obligations of companies, workers, self-employed or tenants They will hinder access to health services in the national territory.

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The rationale of the reform document is Different levels of funding will be set up keeping in view the need to build competencies and responsibilities of health services and resource management.

“The regional governments consider, with the participation of their citizens and the necessary resources, control of their living and health status, ie, control of the risks that threaten health in the region and their determining factors”, reads the text.

control of resources by the state

Nor is there an opposition as such between the state and the market, but rather an indissoluble relationship. “In this project, the nationalization of health is not intended, but to guarantee the right to health with greater state control, technological management tools and transparency in the use of resources,” he says.

eliminate inequality in the system

“Three decades of privatization of health in Colombia have naturalized and consolidated the alienation of citizens, Based on its economic potential, a nation already recognized for being one of the most unequal and unequal societies in the world. This means that, if you want to build a fairer and more equitable society for the future, eliminating the deep inequalities and inequities generated by the health professions will be a dire necessity, or what is it, Destroy this health system and build another in which the life and health of those who have money are not more valuable than the life And the health of those who do not have it.

organization of services

Comprehensive and Persistent Primary Health Care (APIS) – Health care for population groups in the region as a public function. Furthermore, active participation of communities, effective social participation that empowers the population in decision making. The text talks about improving the quality of life of the population in their areas.

Comprehensive Health Services Network (RISS)

group of organizations or networks providing services, of a public, private or mixed nature 0 They agree to provide quality, equitable, comprehensive, integrated, timely and continuous individual and collective health services to the population located in a specific population location in a coordinated and efficient manner to guarantee the effective enjoyment of the right to health Huh. of people and communities.

Talk about the social determinants of health To pursue a preventive model.

National Interregional Commission on Determinants of Health: All cabinets are made up of ministers. It will participate in the formulation of the National Development Plan.

Departmental, district, municipal commissions on health determinants: They would be composed of governors and municipal and district mayors.

Ministry of Health and Regional Directorate of Health

They will form the National Health CouncilWith decision-making autonomy, who will be in charge of coordinating initiatives in the area of ​​public health policy, regulatory initiatives, and evaluating the operation of the system.

It will be attended by 41 people, including representatives from all walks of life.

Tasked, among others, the Ministry of Health, to propose national public health policies, especially public health.

Regional Health Councils will be formed

They aim to develop strategies to guarantee the regional application of public health policies.

financing and operations

This will be done in a decentralized manner with the municipalities.

Primary Care Center (CAP)

Headquarters of programs and teams for health promotion, disease prevention and strengthening social partnerships with assigned populations.

They will be responsible for consolidating information on the total population under their care, planning basic services, and carrying out promotional and prevention operations. They will also be responsible for epidemiological surveillance of the population assigned to the concerned centre.

population responsibility

Municipalities and districts will define the location and population responsibility of primary care centers within their jurisdiction, they will locate the headquarters and appoint the director of the center and his professional and technical team, a necessary condition for allocating primary care to the population Group budget.

They will also be the headquarters for programs and teams for health promotion, disease prevention, and strengthening social partnerships with assigned populations.

They will also be the point of origin for referral orders for the care of populations assigned to hospital and specialized networks of medium and high complexity.

population vs resources by direct twist

All families must be linked to a primary care center based on their place of residence (neighborhood, corrigimiento, municipality), ie there will be registration.

Primary care centers will have a standard organization and budget set by the Ministry of Health.

When direct assessment by a specialist is required, they must integrate diagnosis of moderate complexity and interactive consultations with online experts, without adversely affecting the user’s referral to health services.

Primary care resources will be transferred directly to each care center depending on its type related to the registered population in the area.

investment plan

A 10-year investment plan in primary care centers will be developed for at least one center for every 20,000 residents.

Technical management and transparency of primary care resources

They announce the creation of local public health planning and assessment units for populations between 50,000 and 500,000 residents.

What do they do in CAP?

patient referral

The CAP should have a technical team for referral of patients to networks of medium and high complexity, supported by modern information systems.

emergency situation

Municipal and district health directorates would be responsible for a single pre-hospital emergency care service, which could be integrated with emergency services such as fire departments or the Red Cross. Likewise, they are responsible for coordinating basic home care services for emergency networks, people with limited mobility and people who are homeless or in a precarious social situation.

Moderate and High Complexity – Holistic Healthcare Network – RIIS

They will be provided by public, private and mixed hospital and outpatient institutions that are integrated into the service network of the area or region.

Institutions providing private and hybrid health services may be part of an integrated and comprehensive network of health services to guarantee the fundamental right to health. They will be provided in accordance with the needs and requests of the reference system, under a single rate regime, in accordance with the terms of payment of the said services and the generation of information reports.

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