After an extensive day of debates, the Colombian House of Representatives approved the controversial health reform presented by the Government of Gustavo Petro nine months ago.
The House of Representatives discussed the Colombian president’s flagship health project for several months. However, after almost 10 hours of discussion, 10 articles were eliminated, and 133 were approved of Petro’s initial proposal.
The legislative initiative, which proposes a profound transformation in the country’s health system, did not have the support of members of the Conservative Party, Cambio Radical and the Democratic Center. However, it received crucial support from parties that have historically supported the government such as the Liberal Party, the Party of the U, the Historical Pact, the Commons Party and some members of the Green Party.
Despite this, for the law to be approved, it will first have to face other challenges. The reform must be debated in the Seventh Commission of the Senate, where the government has several like-minded senators, and then it will face some strong opposition in the Senate Plenary.
🚨 ATENCIÓN 🚨 Acaba de aprobarse la reforma a la salud en la plenaria de la Cámara de Representantes. El proyecto ahora pasará a su discusión en el Senado de la República. pic.twitter.com/uRLTHC05B1
— Cámara de Representantes de Colombia (@CamaraColombia) December 6, 2023
What does the reform consist of?
Petro’s proposal aims to transform Health Promotion Entities (EPS) into health managers, and for the state to be the one that directly administers the sector’s funds and makes direct payments to hospitals, clinics and service providers. This would give the government greater control and management capacity over the health system’s resources.
According to the director of the Colombian Association of Comprehensive Medicine Companies (Acemi), Ana María Vesga, currently more than 90% of medical services are provided by private companies, so what Petro seeks is to give the government a predominant role in resource management.
The reform’s most important approved articles
During the chamber session, articles 122 and 123 were approved by an absolute majority, granting the president extraordinary powers to issue regulations with the force of law, especially to change the Indigenous and Intercultural Health System and regulate the intercultural health model in the territories of specific communities.
Another victory for Petro was the approval of articles 55, 56, 66, 67, 69, 72 and 75, ensuring that the funds intended for the payment of Health Providing Institutions (IPS) are transferred directly by the state through the Administrator of the Funds of the General Health Social Security System (Adres).
With the approval of articles 48, 49, 50, 52, 53, 54, 71, 125, 130 and 131, the EPS become “Life and Health Managers,” which gives them two years to define their transformation into Health and Life Management Entities (EGSV).
Likewise, Primary Health Care Centers (CAPS) were approved, and the project establishes that citizens must join the CAPS closest to their home and be referred to another only if they need specialized care.
The reform would be “a setback” for Colombia’s health system
After the approval of the controversial reform in the House of Representatives, several politicians and experts have come out to give their opinions on the issue and warn about how dangerous it would be to convert this project into law.
“The reform approved in the House is inconvenient, it would mean a setback for patients and would put at risk the most important social achievement of the country in the last thirty years. We will continue to insist on the arguments. I trust that these will finally prevail over clientelism,” said former Minister of Health and Education Alejandro Gaviria.
El debate sobre la reforma a la salud continua. La reforma aprobada en la Cámara es inconveniente, significaría un retroceso para los pacientes y pondría en riesgo el logro social más importante del país de los últimos treinta años.
Seguiremos insistiendo en los argumentos.…
— Alejandro Gaviria (@agaviriau) December 6, 2023
Other former health ministers have joined in criticizing the reform, highlighting that if this project becomes law, not only could it make accessing services more difficult, but it also takes away the ability of patients to choose where they want to be treated. Likewise, they highlighted that this reform presents a greater risk of corruption.
Riesgos de la reforma a la salud para los colombianos pic.twitter.com/5W0BPxWHRc
— Alejandro Gaviria (@agaviriau) December 1, 2023
Representative Catherine Juvinao also explained the reasons why she believes that approving the reform would be negative for Colombia and recalled that now the Senate is the one who has the responsibility of deciding “if it destroys the health system” or if it “puts interest and health first.”
Voté NO a una reforma a la salud que:
-No solucionará la crisis financiera del sistema, la agravará.
-No está centrada en el paciente/ciudadano sino en quién maneja la chequera.
-Fragmenta peligrosamente los servicios de salud.
-Elimina el derecho fundamental a la libre… pic.twitter.com/eUETPTX9Ff
— Cathy Juvinao 🏛🇨🇴 (@CathyJuvinao) December 6, 2023