Healthcare Reform in Colombia for 2024

In this article Correcol outlines the latest in Healthcare Reform in Colombia for 2024 and its effects on health insurance. If healthcare law amendments are passed, they could take a well-functioning private/public healthcare system and return it to bureaucratization and inefficiency.

The Colombian government has presented a comprehensive reform project for the healthcare system, aiming to amend Law 100 of 1993, which created the comprehensive social security system in Colombia. This law was created in response to the bureaucracy and inefficiency of the healthcare service, which affected the social needs of the time.

The system based on Law 100 has been functioning adequately in Colombia for over 30 years through a synergy composed of a public sector of social security and an exclusively private sector, primarily represented by the so-called Healthcare Provider Entities (EPS), which serve as a service link and resource channel between the State and Healthcare Provider Institutions (IPS) as delegates of the Solidarity and Guarantee Fund for the collection of contributions from affiliates to the General Social Security System.

The current system, integrated by the public and private sectors, has demonstrated its capacity and functionality to adequately address the services demanded by the population, which has been considered one of the strengths or advantages of the current system.

However, understanding that a healthcare system must respond to a service delivery structure for an inherently dynamic social community, such a system must also evolve and adapt to new social and economic needs.

Healthcare sector objects to proposed reforms

Within this context, it should be understood that reforms may be proposed but authorized critics from different sectors, especially the healthcare sector, insist that the reform proposed by the government does not respond to these social needs but rather to a state’s desire to fully control not only the system but, mainly, the substantial resources involved, thus returning to the previous bureaucratization and inefficiency.

In this scenario, one of the pivotal points of the reform project would be the elimination of the EPS, which would consolidate the feared state control over the system and its resources.

To push forward its aspirations, the government has even used resources that have not been well received by the public and healthcare guilds, such as intervening in some EPS that would have deficit financial states. This intervention is ongoing, and the final result has not yet been seen.

What employers need to know

What is certain, however, is that this state of affairs represents a risk to the current system and may affect the basic healthcare coverage of Colombians due to the return of bureaucracy and inefficiency. In response to this, with a vision of challenge and opportunity, it would be appropriate to encourage and expect greater scope for the promotion and sale of health insurance, hospitalization and surgeries, prepaid medicine contracts, complementary health plans, and other related services such as accidents, disabilities, benefits for dismemberment, serious illnesses, etc.

The reform project is currently archived, but joint government and EPS commissions or working teams are collaborating on the development of a new draft, the main aspects of which we hope will be announced soon.

 

 

This information about healthcare reform in Colombia for 2204 is provided by Correcol, Asinta’s employee benefits consulting partner in Colombia. If you need support with your benefits in the country, please contact Asinta, and we will put you in touch with the local experts at Correcol.