Points to understand the Health Reform in Colombia

Since Wednesday (April 28) of last week, thousands of Colombians have demonstrated against the tax reform proposed by the current government, but since the protesters have advanced, the speech has turned into a broader protest against the government of President Iván Duque.

Within this range of protests, an issue that has not been highly visible at the international level has crept in: health reform. This debate will be imminent, therefore, here we present a context of what has happened in Colombia regarding this reform, explaining it through 5 key points.

Also read: Why are Colombians on strike on April 28?

The prohibition of the outsourcing of health workers

The reform takes into account new payment and contracting mechanisms that prohibit outsourcing (also called subcontracting) in health sector professionals; likewise, it promotes the training of experts in accordance with the needs of the new health delivery model.

However, congressmen and union leaders have affirmed that this is not as beneficial as it appears, since the deep gaps of inequality in labor hiring within the sector are not resolved, for which they say that the wording is alien to the Colombian reality.

The new modality of the National Cancer Institute

From being an autonomous body, the National Cancer Institute of Colombia passes into the hands of the state public administration, in other words into the hands of the executive; Although the reasons for this new modality argue better management of the institute giving it greater public value, there are critical voices that mention the opposite, since they consider that what is intended is to deliver the clinic to large businessmen.

The regionalization of the health system

A subject of great controversy is regionalization, and the motivation to reach the most remote areas. The project plans to decentralize health care through the establishment of regional divisions.

However, some people have warned that to achieve this objective it is necessary to empower current Health Promoting Entities (EPS) and territorial entities, but they would choose to concentrate their efforts in urban areas to invest more in development and technology, leaving aside from people in remote communities.

The elimination of Health Promotion Entities

Benefit Plan Administrators (EAPB) will be created, under the argument of improving quality standards, it is intended that there will be fewer health promoting companies, but that they provide a first level service.

However, this could be a disguised speech, since the reform will not change the role of the EPS, since the financing mechanisms do not change and there is a risk that foreign companies take over the sector, forming oligopolies that will only worsen the quality of the services.

A family health approach

In order to improve prevention and a prior care approach in the health system, the objective is to implement the specialty of family medicine as the central axis of the Colombian health system.

But critical voices affirm that due to the budget constraint, this family doctor allocation mechanism would only generate additional expenses necessary for the sector, punishing companies that keep their administrative and financial requirements up to date.

The foregoing without mentioning that access to the necessary specialties for the care of various diseases could be limited. Therefore, the question arises: Are there really all the professionals specialized in family health? And if not, where would the budget come from?

Without a doubt, the reform is positioned as the next great uproar on the Colombian legislative agenda, and in the face of such an adverse political environment, a turbulent period appears to be in this possible approval; meanwhile, some of its authors have already requested that the initiative be withdrawn.