Colombia Resumes Health Reform Debate Amidst EPS Crisis

The President of the House of Representatives, Andrés Calle Aguas, announced that next week parliamentary political debate on healthcare reform will resume. Aguas made this statement at an event in Cienaga de Oro (Cordoba), alongside President Gustavo Petro. This announcement comes a few days after the letter from the three major Health Promoting Companies (EPS) was sent to the Minister of Health, explaining the economic difficulties these entities are facing.

Healthcare Reform Continues

“We made a commitment to God and to this project of change, being in the Presidency of the House of Representatives, and this has to result in achieving the agenda of change. And so, from the Presidency of the House, we will begin debates on these reforms starting next week,” said Andrés Calle in Ciénaga this week.

With this announcement, a debate that was cut short months ago, marked by a resounding failure, is being revived. The healthcare reform proposal presented by the Petro government, and defended by former Health Minister Carolina Corcho, is based on the concept of health as a universal right. In this context, the role of EPS would change substantially, as health would play a central role in favor of the public sector. Like now, the main financier would be the State, which would also take over much of the management currently held by the private sector.

In the first debate, consensus was not reached. The consequences of this failure included the rupture of the government coalition, with liberals, conservatives, and the Party of the U refusing to support the proposal. In the end, the disagreement led to the resignation of Minister Corcho.

Now, with the announcement from the President of the House of Representatives, the challenge of getting Colombia to approve a healthcare reform, a significant point of the so-called “Government of Change,” is being reopened. Guillermo Jaramillo, Corcho’s successor, faces the challenge of achieving this approval.

EPS Enter the Debate

Just this week, a letter from Colombia’s three most important EPS companies – Sanitas, Sura, and Famisamar – was made public. The companies sent this letter to the Ministry of Health in late July. In it, the companies highlighted the economic difficulties their respective health providers were facing and requested more government funding. Failing this, the EPS mentioned “serious” difficulties beginning as early as September of this year.

Health Minister Guillermo Jaramillo has sought to reassure users. He gave assurances that the government has the necessary resources to guarantee citizens’ health. The minister was clear about the EPS’s attitude, stating that there is no reason to talk about a crisis that doesn’t exist in the sector. Jaramillo also reminded EPS that it is their duty to provide healthcare services.

In this regard, he criticized the fact that while EPS talk about current losses, they don’t mention the profits accumulated in 2020 and 2021. Jaramillo asserted that the “government faithfully fulfills everything that is budgeted.”

Similarly, President Petro commented on the EPS statement on social media. Petro didn’t lend credence to the major EPS claims about liquidity problems due to delays in payment from the administrator of healthcare sector resources, ADRES. The president also reminded that his government has increased EPS financing by 25% for 2023 and that resources for the end of the year are guaranteed.

Need for Agreements

The situation highlights the need to reach agreements to ensure the success of the reform, which cannot be approved without consensus from other political forces. Drawing from the experience of the first reform attempt, championed by Carolina Corcho, the debate must include the generosity of political forces.

Beyond the seats of the “Pacto Historico,” the force supporting the president, the participation of more parties is necessary to secure a majority in the chambers.