BTN News: In a renewed effort to overhaul the healthcare system, Colombia’s Ministry of Health has introduced a revised health reform proposal in 2024, now with 48 articles compared to the original 130. Despite the reduction in length, the core objective remains unchanged: to transform the Colombian healthcare landscape by guaranteeing universal access, eliminating inequalities, and emphasizing primary care. Health Minister Guillermo Alfonso Jaramillo asserts that this latest version streamlines the reform’s scope while retaining its essential elements, signaling the government’s determination to press forward with the proposed changes. Backed by financial assurances from the Ministry of Finance, this reform aims to restructure healthcare delivery and funding, ensuring a fairer and more efficient system for all Colombians.
A Leaner Proposal with the Same Ambitions
The latest version of the health reform in Colombia is more concise, moving from 130 to 48 articles. However, according to Health Minister Guillermo Alfonso Jaramillo, the reduced size does not signify a dilution of its goals. “There is no new bill here,” Jaramillo clarified, emphasizing that the government is merely refining the existing proposal. “We are continuing with the project delivered a year and a half ago, focusing on how to implement it effectively.”
Financial Backing and Presidential Approval Secured
A critical aspect of any reform is its financial viability. Jaramillo reassured the public, stating that the Ministry of Finance has given its financial approval, which was a key step in moving the proposal forward. “The financial endorsement is in place,” he confirmed, noting that the delay in submitting the revised proposal was due to a thorough review of the fiscal details. This step also required the green light from the presidency, which has been secured. “We have balanced the resources and expenses to align with the fiscal framework for both short and long-term plans,” Jaramillo added.
Key Changes: What the Reform Entails
1. Strengthening State Leadership in Healthcare
Under the new proposal, the Ministry of Health will take on a more central role in decision-making and policy formulation. A National Health Council will be established to encourage participation from various stakeholders. The goal is to enhance governance, efficiency, and transparency in managing health resources through a unified health information system.
2. EPS Transformation to Health and Life Managers
One of the most significant changes involves transforming the existing EPS (Health Promoting Entities) into public, private, or mixed entities known as Health and Life Managers. These organizations will coordinate healthcare services and manage provider networks, eliminating vertical integration and promoting direct hiring of healthcare workers.
3. Creation of Integrated Territorial Health Networks (RIITS)
The reform aims to establish Integrated Territorial Health Networks to streamline services from primary care to high-complexity levels. This integration is designed to ensure continuous and timely access to healthcare for all populations.
4. A Unified Public Health Fund for Equitable Financing
A new Single Public Health Fund will centralize the financial resources of the healthcare system. The fund will include specific accounts for primary care and the enhancement of the public hospital network, utilizing a capitation payment model adjusted for health risks and socioeconomic conditions to ensure fair distribution of funds.
5. Strengthening Primary Healthcare Services
Primary healthcare will be the cornerstone of the new system. Primary Care Centers (CAPS) will serve as the main entry points for healthcare, providing comprehensive services tailored to local populations. Additionally, territorial health teams will be deployed to deliver care in rural and remote areas.
6. Formalization of Health Workforce and Better Working Conditions
The reform also addresses labor conditions, mandating the direct hiring of healthcare workers and establishing a special employment regime for public sector health workers to enhance job security and satisfaction.
7. A Gradual and Managed Transition Process
To ensure stability and avoid service disruptions, the implementation of these changes will be gradual and progressive. This approach aims to maintain continuity of care, ensuring that no one is left without coverage during the transition period.
Expert Insights on the 2024 Health Reform
Luis Jorge Hernández, Director of Research at the Faculty of Medicine of the University of the Andes, agrees that the essence of the reform remains consistent with its original objectives. “There are no major changes from the first reform,” Hernández stated. He highlighted that the proposal still seeks to replace the EPS model and move towards a Social Health Insurance model focused on Primary Health Care (APS). The reform’s ultimate goal, he noted, is to guarantee the fundamental right to health for all Colombians, reducing existing disparities in access and quality of services.
Conclusion: Moving Forward with a Clear Vision
As the Colombian government pushes forward with its health reform, the focus remains on achieving universal access, equity, and improved health outcomes for all citizens. The reduced number of articles in the proposal reflects a strategic effort to simplify and accelerate the reform process by addressing some issues through regulatory changes rather than legislative amendments. With financial backing secured and a clear path outlined, the 2024 health reform represents a decisive step towards transforming Colombia’s healthcare system for the better.
