Fedesarrollo presented a proposal to improve the Colombian health system based on 10 thematic axes, taking into account the diversity of municipalities in Colombia and the need to design management models adapted to their specificities.
For the Center for Economic Studies, the reform project submitted by the national government and currently under consideration by Congress raises several concerns.
Some of the critical issues include processing, suppression of rights, non-regression, tax costs, allocation of responsibilities, institutional structure, capacity of territorial entities, continuity of care for chronic patients, and management of maternity and disability leave.
To develop its proposal, Fedesarrollo classifies the country’s municipalities into three categories to facilitate the design of specific policies and strategies.
One of these is the urban centres, where primary care, promotion and prevention must be improved, administrative procedures reduced and technologies and interoperable information systems introduced.
The second is intermediary cities and towns, which should adopt care models that combine primary care and specialized care, take advantage of resources such as telehealth, and improve the training and retention of health workers.
In third place are small and rural municipalities, where primary care needs to be emphasized, staff shortages need to be addressed with telehealth and home care, and special maternity and childcare programs need to be developed. Recommendations are made in ten main axes.
The ten axes presented by Fedesarrollo in his proposal are:
1. Structuring comprehensive and integrated networks at regional level
2. Design and implement the PHC model with a territorial approach
3. Strengthening the hospital network
4. Human talent policy in healthcare
5. Financial sustainability
6. Hiring EPS-IPS 7. Strengthening the SNS
8. Coordinating bodies
9. Public Health
10. Public, Interoperable and Transaction Information System.
Fedesarrollo’s analysis shows that the Colombian health system has seen significant improvements over the past 30 years, with universal insurance coverage, low out-of-pocket expenses and a household financial protection plan against catastrophic expenses.
The Benefits Plan has also been expanded, which today equally covers the premium and subsidized regimes. Despite these advances in coverage and fairness, the system still raises issues and legitimate complaints that need urgent resolution.
“However, it is important to recognize the achievements and avoid returning to the situation three decades ago, when disease led to the economic ruin of families,” he says.
It notes that the three main issues in the health sector to be addressed in health reform are sub-optimal levels of health service delivery with significant disparities in supply, access, quality and opportunity between different populations (according to occupation and income), between urban and rural areas of the country, especially the most remote ones.
Also that the health system faces problems of insufficient resources and financial sustainability. Expenditures exceed revenues, creating annual deficits and accumulating debt that jeopardizes the system.
The health sector shows weaknesses in its institutional structure and governance, which translates into a lack of coordination between policies, actors and levels of government, making it difficult to guarantee the right to health. In addition, the system is fragmented and unbalanced in terms of financial risk, with negative incentives to access and positive incentives to generate spending.
Source: El heraldo
Roy Brown is a renowned economist and author at The Nation View. He has a deep understanding of the global economy and its intricacies. He writes about a wide range of economic topics, including monetary policy, fiscal policy, international trade, and labor markets.
