Concern continues about the elimination of add-on plans and the increase in the cost of prepaid

This Monday, May 29, the paper for the second debate on health reform was filed. Despite the consensus in the Seventh Commission of the House of Representatives, the controversial project of the national government continues to cause concern to the EPS union due to the elimination of complementary plans.

In the midst of the discussion in the Seventh Commission, article 131 was eliminated, which proposed that no person who had prepaid medicine could have additional benefits, such as those who have complementary plans.

Despite this, according to Paula Acosta, president of the Colombian Association of Comprehensive Medicine Companies (Acemi), there is uncertainty about the elimination of the Health Benefits Plan (PBS) and complementary plans, which allow those affiliated with some EPS to access to hotel services and improvements in the hospitalization service.

On the other hand, the union leader assures that there is a “separation” in the health system that would directly impact the pockets of those who purchase prepaid medicine plans.

“On the other hand, the health system is separated, where we return to what we had thirty years ago. On the one hand, there are some private insurance policies or prepaid medicine that are not connected to the health system, so what is to be expected is that there will be a very significant increase in the costs of these health policies or in this prepaid medicine. ”, added the president of Acemi.

The warnings of Transparency for Colombia regarding the health reform

Through a press release, Transparency for Colombia and Así Vamos en Salud shared with public opinion a series of recommendations on the health reform bill, with a view to reducing the risks of corruption and political interference.

“The analysis begins by recognizing that health systems face risks of corruption due to the huge public budgets they manage, the lack and asymmetry of information among the multiple actors involved, and the complexity in the governance and regulation of the systems. ”, the organizations indicated in the document.

Among other things, they indicated that they reviewed about 67 cases of corruption that occurred in Colombia between 2016 and 2020. They indicated that these irregularities were of an administrative, private and political nature and would have cost the country 1.63 trillion pesos.

“Public servants were responsible for 46.2% of these cases. Private actors also played an important role in 37.3% of the registered cases. The most common crimes associated with corruption were entering into contracts without complying with legal requirements and prevarication by omission. About 25% of the corruption cases were related to irregularities in the supply of medicines, such as cost overruns, fictitious beneficiaries, charges for undelivered medicines, trafficking and counterfeit medicines,” the organizations noted in the document.

To that extent, They made recommendations on three key aspects to improve aspects such as governance and the visibility of management in the new health model proposed by the reform.

“The reform can correct situations that have facilitated serious cases of corruption in the health system, however, the proposal that Congress is discussing is highly complex and requires concrete and strategic measures to avoid risks of embezzlement, politicization and clientelism in the system ”, said Andrés Hernández, director of Transparency for Colombia.

Among other things, they pointed out that the profound transformations that the health system budget will undergo will bring multiple challenges. This “could generate a risk of opacity in the information,” the organizations warned.

“A strategy of budget transparency is required that involves all the sources that will finance the system, as well as the obligatory nature of the publicity of the contracting information, including the contracting associated with the National Health Equipment Plan that would include the resources that are invested. in infrastructure and system endowment”, they added.

Instead, they advised, consideration should be given to creating effective systems interoperability schemes that already exist in the current health system.

In addition, they indicated that the text of the articles proposes that medicines be purchased centrally, for which reason They recommended that the measure be accompanied by “clear and objective” criteria to materialize these transactions.