At times when talking about a structural health reformthe country calls for a broad, structured and targeted debate among all participants, in which all elements related to this problem, which affects the entire population, will be affected.
In this sense, EL TIEMPO presents the first of these necessary discussions, in which representatives of the government, supervisory authorities and the most authorized voices of this sector in the country participate simultaneously and personally.
‘Health reform, national dialogue needed” is the name of the industry forum held by the EL TIEMPO Editorial House with the presence of the Minister of Health, the National Inspector of Health and other government representatives who will talk to representatives of all trade unions which bring together EPS, public and private hospitals, researchers, medical associations and patients in a proactive context that allows progress given the conjunctural moment that healthcare in the country is going through.
The event takes place in three panels, which will discuss the topics of insurance, models of care and resource flows, around the proposals for change proposed by the government.
Follow the event minute by minute here.
Minute after minute
A model of care, a gap to be filled panel
Panelists in this segment are Luis Alberto Martínez, Deputy Minister of Social Protection; Olga Lucia Zuluaga, director of the Colombian Association of Public Social Enterprises and Public Hospitals (Acesi); Julio Cesar Castellanos, Director of the San Ignacio University Hospital (HUSI); Enrique Peñalosa, Academician of Pontificia U. Javeriana, and Jorge Alberto Toro, Director of Unión IPS de Colombia.
The guests are unanimous that the current health model should be transferred from paper to practice and reach the entire population of the country without any discrimination.
According to the panelists, among the main problems of the current health care model in the country is the lack of resources to allow it to be delivered to the entire population that needs it, the lack of coverage of the national territory, the lack of articulation with territorial entities and some models of negotiation with the various participants in the insurance chain, among others.
How does the director of Acesi see the government’s proposal to focus on promotion and prevention?
“It’s a duty and it’s what the system has been asking for for a long time,” Zuluaga says. He adds that the proposal of the union he represents is for the public hospital not to depend on the sale of services, but for resources to depend on the population it is responsible for and to be funded directly by the national government.
How do IPS fit into this model?
Toro asserts that private hospitals of varying levels of sophistication have always contributed to prevention models. He adds that a dialogue between the public and the private should be started.
What does Dr. Zuluaga think about the belief that public hospitals in the regions are in the grip of “politics” and corruption?
Acesi’s representative mentions that the difficulties of public hospitals do not have a single cause; among them he points to underfunding. On corruption, he assures that there are various challenges, such as ensuring that those who come to lead are based on merit and that there are integrated networks that generate more cooperation than competition between the public and private.
Integrated networks: How to improve the situation with definancing and in what time frame will it be done?
Deputy Minister Martinez emphasizes that some of the funding fronts are related to guaranteeing the right of access for the country’s residents and, on the other hand, that health workers have decent conditions. Thoreau expresses that integrated networks are related to territoriality; this means that the needs of the population of that territory are known in order to know what supplies are needed.
“The drive for profitability, profit and transactions have distracted us from the central picture that the Colombian health system should have, which is to care for the population,” he concludes.
How do you see the integrated networks of health services from your sectors?
Penalosa: He thinks it’s something that is known from theory, but still needs to be integrated. For him, integration models should be considered from the provision of services from low to high complexity.
Castellanos: “the network must have a territorial approach”. However, the law does not allow it, as the regulations say that the networks must be organized by the EPS, according to what he says.
Coverage and access panel
In this excerpt, the panelists are Ulahi Beltran, Chief of Health; Paula Acosta, Executive President of ACEMI (Colombian Association of Complex Medicine Companies); Carlos Daguerre, Director of the Andi Insurance Chamber; Elisa Torrenegra, Executive Director of Gestarsalud; Francisco Castellanos, Patient Advocate (Patient Protection Organization).
There is dialogue on issues such as the work of the EPS, the control tasks of the Health Inspectorate and the objectives of the national government.
Here are some of the highlights and questions from the first panel:
Is there a future for the EPP in this government?
Acosta: Yes, it invites dialogue with the government to talk about the “day-to-day problems of the system.”
Dáguer: “EPS will survive strengthened and fully focused on putting the patient at the center.”
Torrenegra: “Yes. What will be done should be to improve, not put continuity or access at risk.’
Castellanos: “I see a future for those who can provide services as service providers, but not as administrators of a public resource for a specific destination.”
Chief: “Participants who do not add harm to people’s health and lives, avoid avoidable costs to the system and guarantee the right to health will prevail.”
Did the manager come to terminate the EPS?
Ulahi Beltran: “That’s the question I always get asked. First, many of them end on their own; when I arrived they had already settled 14 EPS for non-compliance.’
Does encouraged change mean the disappearance of change? (Related to EPS)
Acosta, Daguerre and Torrenegra say no. For his part, the chief says Congress will decide. Finally, Castellanos assures that “until those responsible for insurance ensure timely access to services and there are deaths that can be prevented, this change must occur and these participants must disappear.”
Do you think the Colombian health system requires changes?
Acosta: requires corrections.
Black Stream: Yes.
Castellanos: requires structural changes.
Beltran: requires deep and structural changes.
Intervention of Minister Karolina Korcho
Questions to the Minister of the representatives of the sector
What is the department’s road map and when will health care reform be presented to Congress?
Korcho confirms that it is scheduled for next semester, as the government’s current priorities are tax reform, the state budget and political reform.
In addition, he again calls for calm. “What the reform will be, the country will know, because this is a public debate. A reform cannot be approved behind closed doors,” he says.
When will there be a dialogue between the government and all actors in the sector?
The minister said that the comments on the civil society proposals for the reform, when the time comes, will be published and sent to all participants in the different regions of the country. This will open the dialog.
‘We want progress in mental health’: Health Minister
“We’re going to launch the mental health shock plan,” Corcio says. As he explains, the aim is to have a greater capacity to respond to specific mental health needs. In this regard, it is also reported that there is an increase in the suicide rate in Colombia.
The minister again called for calm and fight against disinformation. “What we’re going to generate is a lot more pain in a sector that already has them,” he says.
Finally, it invites active participation in the regional dialogues of the National Development Plan 2022-2026.
Concern over mortality rates and winter wave
Corcho refers to the indicators of maternal mortality and mortality of children under one year, he assures that this is one of the points that most worries the government.
Likewise, it refers to the fact that the country needs to prepare and adapt to the challenges posed by the winter waves for different regions of the country. The minister assured that the government is launching the preventive health program this semester. This is why the consolidation of interdisciplinary groups in the country has progressed.
Beginning of the intervention of the Minister of Health
The Minister of Health, Carolina Corcho, began her speech by highlighting the high representation of various actors in the health sector in Colombia.
The official invites any proposal or correction of health care in Colombia to adapt to the existing legal framework in the country. He also calls for calm. “Health care reform is a discussion for next semesterCork says.
And he adds that the government is currently in the process of discussing the tax reform. Health also depends on it, he assures, since at the end of his process there will be clarity about the budget for the sector.
start the discussion
Ernesto Cortés, editor-in-chief of EL TIEMPO, welcomed the event and thanked the presence of the Minister of Health, who will speak first, and the other guests. According to him, the event is relevant because it is a dialogue between all participants in the health sector.