BTN News: The healthcare system in Cali, Colombia, is teetering on the brink of collapse due to significant financial strains. This crisis was brought to the forefront when Cali’s Mayor, Alejandro Eder, addressed a letter to President Gustavo Petro and Health Minister Guillermo Alfonso Jaramillo, highlighting the escalating debts owed by intervened Health Promotion Entities (EPS) to the city’s public healthcare network. This alarming situation prompted immediate action from the National Health Superintendent, Luis Carlos Leal, who convened a crucial meeting with the Governor of Valle del Cauca, Cali’s Health Secretary, hospital managers, and other key officials to devise a strategy to rectify the financial imbalance plaguing the system.
Collaborative Efforts to Address Financial Imbalance
In this pivotal meeting, it was agreed that joint technical working groups would be established to thoroughly assess the hospitals’ financial needs. Despite Mayor Eder’s claim of a systematic shortfall in payments to public and private healthcare providers, the Administrator of the Resources of the System (Adres) clarified that funds are disbursed according to payment orders from the EPS, including those under intervention. To bridge this gap, the Superintendency of Health is formulating measures to ensure payment orders accurately reflect the required amounts for clinics, hospitals, and EPS suppliers.
Luis Carlos Leal Angarita emphasized the commitment to implementing effective control measures to monitor each EPS’s financial transactions. He announced future working sessions with interventors and healthcare providers across the department to refine contractual issues, aiming to stabilize the financial flow within the system.
Dire Consequences if Issues Persist
Mayor Eder warned of the dire consequences if the current situation persists, predicting an imminent shutdown of services that would leave hundreds of thousands without access to healthcare. He called on the national government to urgently normalize the payment flow and implement a structured amortization plan with stringent oversight by the National Health Superintendency and the Ministry of Health.
Financial Disbursements and Outstanding Debts
Adres’s financial records reveal that in the first half of the year, the system recognized a total of $42.32 billion through the Unit of Payment by Capitation (UPC), with $21.58 billion allocated to contributive regime EPS and $20.74 billion to subsidized regime EPS. Additionally, $2.48 billion was disbursed for non-covered health services and technologies.
The introduction of direct transfers has seen $19.52 billion directly paid to health service providers, marking an 88.82% increase compared to the same period in 2023, due to the enactment of Decree 489 of 2024. By June, Adres had transferred $6.95 billion to ensure healthcare services, split almost evenly between subsidized and contributive affiliates. However, persistent delays in EPS payments continue to exacerbate the financial strain on the Valle del Cauca Public Health Network.
Governor’s Proposal and Wider Regional Impact
Governor Dilian Francisca Toro proposed paying 80% of billed amounts to improve resource flow, acknowledging it’s not an ideal solution but a necessary step to maintain service quality and availability. She also advocated for consolidating a network integrating public and private services, aiming for better contractual terms with EPS to enhance patient care.
The health crisis extends beyond Valle del Cauca, affecting regions like Antioquia, where hospitals face delays in salary payments, and Caldas, where EPS debts amount to $567 million, leading to service reductions at critical hospitals. Santander’s hospitals are also burdened with over $300 million in debts, impacting 28 public hospitals.
Nationwide Implications and Teacher Healthcare Crisis
The health sector crisis also affects teachers, with public hospitals in Antioquia halting non-urgent services due to unpaid dues from the National Social Benefits Fund for Teachers (Fomag). Magda Lorena Giraldo, Vice President of the Fiduprevisora Fund, assured that payments are being made on time, provided all administrative documents are complete, and emphasized the importance of adhering to established payment schedules.
Despite these assurances, hospitals face significant financial pressure, with Fomag’s pending payments amounting to approximately $25 million, expected to be disbursed throughout August.
Conclusion: A Call for Immediate Action
The escalating healthcare crisis in Cali and other regions underscores the urgent need for comprehensive government intervention. Ensuring timely payments, improving financial oversight, and fostering collaboration between public and private sectors are critical to stabilizing Colombia’s healthcare system and preventing further service disruptions. As local and national authorities work towards solutions, the health and well-being of millions of Colombians hang in the balance, awaiting decisive and effective action.
